Comparison of nonnavigated and 3-dimensional image-based computer navigated balloon kyphoplasty

Area of Science:

• Minimally Invasive Spine Surgery
• Interventional Radiology
• Orthopedic Surgery

Background:

• Balloon kyphoplasty is a standard treatment for vertebral compression fractures.
• Established benefits include pain relief and deformity prevention.
• The role of image-based navigation in kyphoplasty remains unclear.

Purpose of the Study:

• To compare 3D image-based navigation with conventional fluoroscopy in balloon kyphoplasty.
• To evaluate differences in needle malposition, cement leakage, and radiation exposure.
• To determine the efficacy of navigated versus non-navigated kyphoplasty.

Main Methods:

• A comparative study of 30 balloon kyphoplasty procedures (47 levels).
• 21 cases (36 levels) utilized 3D image-based navigation.
• 9 cases (11 levels) used conventional 2D fluoroscopy.

Main Results:

• The navigated group showed a significantly lower needle malposition rate (3% vs. 27%, P=.04).
• Cement leakage rates were similar between groups (P=.29).
• Radiation exposure times were comparable (98 s/level vs. 125 s/level, P=.10).

Conclusions:

• 3D image-based navigation in balloon kyphoplasty significantly reduces needle malposition.
• Navigation may decrease the need for needle repositioning.
• Overall procedure outcomes regarding cement leakage and radiation exposure were similar.