Prospective Comparative Study in Spine Surgery Between O-Arm and Airo Systems: Efficacy and Radiation Exposure

Area of Science:

• Spine surgery
• Medical imaging
• Neurosurgical navigation

Background:

• Pedicle screw placement is a technically demanding procedure in spinal instrumentation.
• Intraoperative neuronavigation systems aim to improve accuracy and safety during these procedures.

Purpose of the Study:

• To compare the accuracy and radiation exposure of two intraoperative computed tomography-based neuronavigation systems: O-Arm and AIRO.
• To evaluate their effectiveness in thoracolumbar screw instrumentation.

Main Methods:

• A prospective, comparative, nonrandomized study conducted in two French academic centers.
• O-Arm used in Bordeaux, AIRO in Marseille.
• Postoperative CT scans assessed screw placement accuracy; radiation dose data were extracted from system reports.

Main Results:

• Both systems achieved high accuracy rates (90.8% O-Arm, 92.2% AIRO).
• The O-Arm system showed significantly lower radiation exposure for patients (dose length product, mean dose per scan/level) and surgeons (0 μSv) compared to AIRO.
• Significant differences (P < 0.05) were observed in all radiation exposure measures.

Conclusions:

• Intraoperative CT-based navigation enhances pedicle screw accuracy.
• The O-Arm system offers comparable accuracy to AIRO with substantially reduced patient and surgical team radiation exposure.
• This technology represents a significant advancement in spinal surgery safety and precision.