Spinal navigation: an accepted standard of care?

Area of Science:

• Neurosurgery
• Medical Technology
• Spinal Surgery

Background:

• Cranial neuro-navigation is routine, but spinal navigation for pedicle screw insertion remains debated.
• Opinions on spinal navigation range from "not useful" to "malpractice if not used."

Purpose of the Study:

• Assess the availability of spinal navigation in German neurosurgical departments.
• Gauge the common opinion among German neurosurgeons regarding the usefulness of spinal navigation for pedicle screw placement.
• Review current literature on spinal navigation.

Main Methods:

• Survey distributed to German neurosurgical departments via the Commission for Technical Standards of the German Neurosurgical Society.
• Data collected on the availability and usage of intraoperative computerised spinal navigation systems.

Main Results:

• 84% of surveyed departments responded; 53% have spinal navigation, 11% share it, and 36% do not.
• Nearly 50% of responders believe spinal navigation enhances safety for pedicle screw insertion, while 37% disagree.
• 94% disagree that spinal navigation should be mandatory, and 98% reject the notion that screw placement without it constitutes malpractice.

Conclusions:

• Spinal navigation is not yet standard practice for pedicle screw implantation; conventional methods still dominate.
• Despite perceived safety benefits by nearly half of neurosurgeons, mandatory use is rejected.
• The German neurosurgical community largely rejects the idea that omitting spinal navigation constitutes medical malpractice.