Surface Navigation and the Influence of Navigation on MIS Surgery

Abstract

Study Design: Literature review. Objectives: To review the evidence for surface-based navigation in minimally-invasive spine surgery (MIS), provide an outline for its workflow, and present a wide range of MIS case examples in which surface-based navigation may be advantageous. Methods: A comprehensive review of the literature and compilation of findings related to surface-based navigation in MIS was performed. Workflow and case examples utilizing surface-based navigation were described. Results: The nascent literature regarding surface-based intraoperative navigation (ION) in spine surgery is encouraging and initial studies have shown that surface-based navigation can allow for accurate pedicle screw placement and decreased operative time, fluoroscopy time, and radiation exposure when compared to traditional fluoroscopic imaging. Surface-based navigation may be particularly useful in MIS cervical and lumbar decompressions and MIS lumbar instrumentation cases. Conclusions: Overall, it is possible that surface-based ION will become a mainstay in the armamentarium of enabling technologies utilized by minimally-invasive spine surgeons, but further studies are needed assessing its accuracy, complications, and cost-effectiveness.

A novel method to evaluate transverse pedicle angle of lower lumbar using digital radiography

“…In recent years, some initial studies about accurate medicine attract people's attention, many technology were used to improve the accuracy of pedicle screw insertion, such as computer-based navigation and robotic-assisted guidance systems [20][21][22][23][24] , pedicle screw entry point [25][26][27] , TPA of lumbar 17,18,28 , both scan-and-plan registration and CT-to-uoroscopy registration methods is similar uoroscopy time exposure 29 . Still, recent reviews demonstrate that these instrument are no better than freehand technologies, but also substantially increase the costs and operation time 12,30,31 .…”

CORR Insights®: Reoperation Rates of Microendoscopic Discectomy Compared With Conventional Open Lumbar Discectomy: A Large-database Study

“…The radiation exposure is clearly larger in microendoscopic discectomy. However, fluoroscopy delivers a two-dimensional image in one plane of orientation, and placement of guidewires during microendoscopic discectomy can be challenging because several punctures might be needed to position the guidewires adequately [1]. Three-dimensional navigation and robotic assistance can considerably improve accuracy during positioning [5, 9].…”

“…L. F. H. Theyse ✉, College of Veterinary Medicine, Department for Small Animals, University of Leipzig, An den Tierkliniken 23, D-04103 Leipzig, Germany, Email: lars. theyse@kleintierklinik.uni-leipzig.de guidewires adequately [1]. Threedimensional navigation and robotic assistance can considerably improve accuracy during positioning [5,9].…”

Comparison of Robotics and Navigation for Clinical Outcomes Following Minimally Invasive Lumbar Fusion

“…1 Spine surgery has followed suit with the evolution of navigation and robotics over the last two decades as new imaging and assistive modalities. [2][3][4][5][6][7][8][9] In comparing the two modalities for lumbar spine surgery, several studies have demonstrated the potential benefits of robotics over navigation. Roboticassisted pedicle screws have been shown to have greater accuracy 10,11 and allow for greater screw diameter and length when compared with navigation, resulting in more optimal screw placement.…”

“…Across all fields of surgical practice, there has been a significant shift toward the adaptation of new technologies in the operating room 1 . Spine surgery has followed suit with the evolution of navigation and robotics over the last two decades as new imaging and assistive modalities 2–9 . In comparing the two modalities for lumbar spine surgery, several studies have demonstrated the potential benefits of robotics over navigation.…”