CT guidance assisted by electromagnetic navigation system for percutaneous fixation by internal cemented screws (FICS)

Objective
To evaluate electromagnetic navigation system (ENS) for percutaneous fixation by internal cemented screw (FICS) under CT guidance.

Outcomes
Mean duration of FICS procedures was 111 ± 51 min. Mean post-procedure hospitalization length was 2.1 days. Technical success was achieved in 48 cases (96%) with a total of 76 screws inserted. Mean distance p, mean distance d, and mean angle θ were respectively 8.0 ± 4.5 mm, 7.5 ± 4.4 mm, and 5.4 ± 2°. Angle θ accuracy was higher for screws with a craniocaudal angulation of less than 20° (4.4° vs 6.4°, p = 0.02). The mean number of CT acquisitions during procedures was 6.4 ± 3.0. The mean dose length product was 1524 ± 953 mGy cm and the mean dose area product was 12 ± 8 Gy cm2. Five complications occurred in 4 patients.

Key Points

• ENS-assisted CT enables screw insertion in the pelvic ring and femoral neck, with a wide range of trajectories, even when a significant craniocaudal angulation is required.
• ENS-assisted CT can be used as an alternative to CBCT guidance for percutaneous fixation by internal cemented screw.
• ENS-assisted CT provides high technical success rate with excellent placement accuracy.

Publication 
CT guidance assisted by electromagnetic navigation system for percutaneous fixation by internal cemented screws (FICS). B. Moulin, L. Tselikas, T. De Baere, F. Varin, A. Abed, L. Debays, C. Bardoulat, A. Hakime, C. Teriitehau, F. Deschamps

European Radiology, September 2, 2019