Electromagnetic Navigation in Biportal Endoscopic Lumbar Spine Surgery

Area of Science:

• Minimally Invasive Spine Surgery
• Surgical Navigation Technology
• Spinal Decompression Techniques

Background:

• Endoscopic Spine Surgery (ESS) is an emerging alternative to traditional microscopic spine surgery for lumbar decompression.
• A significant challenge in ESS is its steep learning curve.
• Navigation integration into ESS aims to simplify the learning curve and enhance surgical precision.

Purpose of the Study:

• To describe the experience and feasibility of using electromagnetic navigation in biportal endoscopic spine surgery (BESS).
• To evaluate the utility of navigation in confirming surgical levels and assessing decompression extent.
• To assess the impact of navigation on intraoperative imaging requirements.

Main Methods:

• Patient positioning and setup of the electromagnetic navigation system, including patient mappers and tracker implantation.
• Performance of standard endoscopic decompression procedures following navigation system setup.
• Utilization of navigation instruments for intraoperative confirmation of surgical level, angulation, and decompression extent.

Main Results:

• The use of electromagnetic navigation reduced the reliance on intraoperative imaging during BESS.
• The system provided accurate confirmation of the surgical level and extent of decompression.
• A notable drawback was the significantly long setup time required for the navigation system.

Conclusions:

• Electromagnetic navigation in BESS offers an accurate alternative to repeated intraoperative imaging.
• The technology has the potential to improve safety and efficiency in endoscopic spine procedures.
• Further large-scale trials are necessary to validate the long-term efficacy and cost-effectiveness of this approach.