Clinical Efficiency and Radiation Safety of Fluoroscopy-Based 2D Intraoperative Computer Navigation in Biportal...

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Medical Imaging

Background:

• Endoscopic spine surgery offers benefits like reduced pain and faster recovery.
• Precise navigation in endoscopic spine surgery is challenging, often involving radiation exposure and longer procedures.
• Fluoroscopy-based 2-dimensional navigation (2DNAV) is an emerging technology for real-time guidance.

Purpose of the Study:

• To evaluate the clinical efficiency and radiation safety of 2DNAV in biportal endoscopic spine surgery.
• To compare 2DNAV with conventional C-arm fluoroscopy in terms of operative time, radiation exposure, and clinical outcomes.

Main Methods:

• A prospective comparative cohort study involving 20 patients using 2DNAV and 20 matched controls using C-arm fluoroscopy.
• Primary outcomes included operative time, number of fluoroscopic images, radiation exposure time, and total radiation dose.
• Secondary outcomes assessed using visual analog scale for pain and Oswestry Disability Index.

Main Results:

• The 2DNAV group had significantly shorter operative times (67.95 min vs. 83.0 min, P=0.003).
• Fewer fluoroscopic images (3.15 vs. 17.95, P<0.001) and lower radiation exposure (1.9 min vs. 9.21 min, P<0.001; 0.77 mGy vs. 6.21 mGy, P<0.001) were observed in the 2DNAV group.
• No significant differences in clinical outcomes were found between the groups.

Conclusions:

• 2DNAV significantly reduces operative time and radiation exposure in endoscopic spine surgery.
• The technology allows for successful procedures with comparable clinical outcomes to conventional fluoroscopy.
• 2DNAV provides real-time navigation, enhancing safety and efficiency in minimally invasive spinal procedures.