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After converting the screw, the final accuracy of the screws in postoperative CT was 96.7% (146 of 151). CPS with O-arm navigation showed relatively low accuracy at the mid-cervical level due to vertebral rotation. However, the opportunity to convert the screw from intraoperative 3D reconstructed O-arm images is the advantage of the O-arm navigation, and it showed excellent accuracy. CPS with O-arm navigation showed relatively low accuracy at the mid-cervical level due to vertebral rotation. However, the opportunity to convert the screw from intrao