INTRAOPERATIVE RADIATION CONTROL OF MODERN HIGH-TECH OPERATIONS ON THE SPINE
Background. The authors conducted a retrospective and prospective analysis of the results of 350 operations using the image intensifier tube and 390 operations with the O arm and the Stealth-Station navigation station (Medtronic, USA). Materials and methods. To 350 patients operated on with the use of an image intensifier, 1822 screws were implanted, on average 5.2 screws per operation. 1705 (93.6%) screws were correctly implanted, 117 (6.4%) screws were incorrectly implanted, 90 (4.9%) of them were recognized as acceptable or clinically insignificant malposition of the screw, the remaining 27 (1.5%) were incorrectly installed, the screws required a revision operation. The authors believe that when using an image intensifier tube, the zero degree of malposition of transpedicular screws was observed in 93.6%, the first in 3.3%, the second in 1.7% and the third in 1.5%. Results. To 390 patients operated with O arm, 2477 screws were implanted, on average 6.3 screws during one operation. 2444 (98.7%) were correctly implanted, 33 (1.3%) screws were implanted incorrectly, of which 25 (1%) screws were acceptable malposition and 8 (0.3%) screws were not tolerated during the current operation. The zero degree of screw malposition was observed in 98.7%, the first degree - 0.7%, the second degree - 0.3% and the third degree - 0.3%. Comparative studies of the total number of incorrectly implanted screws during operations using the image intensifier tube and O arm showed that they were more often observed when using the image intensifier tube (p <0.001) and there was no unacceptable malposition of the screws when performing the operation under O arm, since it was diagnosed in a timely manner during current operation and eliminated. Conclusion. O-arm with the Stealth-Station navigation station is the most modern method of controlling the correctness of spinal operations when anatomical landmarks are partially invisible - with open operations. The use of image intensifier tubes for high-tech operations on the spine is still the "gold standard" when performing transpedicular fixation, the number of incorrectly implanted screws decreases with the surgeon's experience.