Çetiner, EyyupAkesen, SelcanBilgin, YücelÖnder, CemGüler, Saltuk BuğraAkesen, Burak2024-09-102024-09-102023-02-28https://doi.org/10.26650/IUITFD.1198451https://iupress.istanbul.edu.tr/en/journal/jmed/article/comparing-the-trajectory-accuracy-of-pedicle-screws-placed-with-a-free-hand-technique-and-a-three-dimensional-computed-tomography-assisted-navigation-system-in-spine-surgery-a-retrospective-studyhttps://hdl.handle.net/11452/44472Objective: We evaluated a free-hand technique and a three-di-mensional computerized tomography (3D-CT)-assisted naviga-tion technique, which are pedicle screw placement techniques used in spinal surgery, regarding screw placement and reliability.Material and Method: A total of 1664 screws in 73 patients with spinal deformities who underwent spinal instrumentation using pedicle screws were evaluated in this study. Forty patients were in the free-hand technique group, and 33 patients were in the 3D-CT-assisted navigation technique group. The placement and reliability of pedicle screws in all patients were evaluated using the Gertzbein-Robbins classification using CT images taken in the postoperative period.Result: There were no significant differences found regarding age, body mass index (BMI), sex (female or male), or deformity (scoliosis or kyphosis) (p>0.05). When the pedicle screws were evaluated in terms of transverse penetration, the 3D-CT-assisted navigation technique was determined Grade A (89.6%), as was the free-hand technique (76.5%), but the 3D-CT-assisted navi-gation technique was statistically more reliable (p<0.001). When the pedicle screws were evaluated in terms of anterior penetra-tion, both the 3D-CT-assisted navigation technique (92.5%) and the free-hand technique (82.9%) were determined Grade A, but the 3D-CT-assisted navigation technique was statistically more reliable (p<0.001).Conclusion: According to our studys results, the 3D-CT-assist-ed navigation technique is more reliable than the free-hand technique in surgeries involving spine deformities for pedicle screw insertion.eninfo:eu-repo/semantics/closedAccessInternal-fixationScoliosisSpine deformityNavigationPosterior instrumenta-tionGeneral & internal medicineArticle00096286700000113814486210.26650/IUITFD.11984511305-6441