Comparing Lumbar Disc Space Preparation With Fluoroscopy Versus Cone Beam-Computed Tomography and Navigation: A...

Area of Science:

• Spine Surgery
• Surgical Navigation
• Medical Imaging

Background:

• Transforaminal lumbar disc space preparation presents visualization challenges.
• Current methods rely on tactile feedback and 2D imaging, limiting precision.

Purpose of the Study:

• To compare the efficacy of disc space preparation using cone beam-computed tomography with navigation (CBCT+N) versus conventional fluoroscopy for instrument placement.

Main Methods:

• A cadaveric study involving eight cadavers and 40 disc space preparations.
• Random assignment of disc levels to either fluoroscopy or CBCT+N guidance.
• Quantification of disc removal percentage using digital imaging software.

Main Results:

• CBCT+N group demonstrated a significantly higher percentage of disc removal compared to the fluoroscopy group (P≤0.0001).
• Increased disc removal was observed in specific quadrants with CBCT+N (P≤0.0001).
• No significant differences were found in procedure time, instrument passes, or endplate violations between the groups.

Conclusions:

• CBCT+N is an effective tool for assessing instrument placement in interbody disc space preparation.
• It offers comparable procedural efficiency and safety to conventional fluoroscopy.