First Generation Computerized Fluoroscopic Navigation in Percutaneous Pelvic Surgery

Percutaneous internal fixation of pelvic fractures has gained popularity allowing rapid mobilization with reduced surgical related morbidity; however, this method depends on conventional fluoroscopy, which exposes the patient and the surgeon to a significant amount of radiation. The use of computerized fluoroscopic navigation systems enables the simultaneous use of several radiographic projections. These preliminary fluoroscopic views are taken when the operating team stands at a distance from the radiation source. No further fluoroscopic radiation is used later during the surgical procedure. Computerized fluoroscopic navigation was used in the percutaneous insertion of 45 cannulated screws in 29 patients, including sacroiliac screws, pubic ramus screws, posterior column screws, and a supraacetabular transverse screw. Fluoroscopic verification of screw placement demonstrated a deviation ≤2 mm and ≤5°. We believe the system saves fluoroscopic radiation time, yet improves the precision of the procedure. We believe that the use of this system is adequate for a selected patient population with pelvic fractures amenable to percutaneous screw fixation.