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Effect of Intraoperative Image-Guided Spinal Navigation Technologies on Endoscopic Lumbar Spine Surgery: A Systematic
Yu-Che Wang1,2, Hsu-I Chou2, Ying-Fong Su3,4
1Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan.
Global Spine Journal
|September 26, 2025
Summary
Intraoperative image-guided spinal navigation improves perioperative outcomes in endoscopic lumbar spine surgery (ELSS) by reducing operation time and radiation exposure. However, it does not significantly impact long-term clinical results compared to conventional methods.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Minimally Invasive Surgery
Background:
- Intraoperative image-guided spinal navigation offers real-time imaging during surgery.
- It can potentially enhance pathology localization and optimize surgical approaches in Endoscopic Lumbar Spine Surgery (ELSS).
- Comparison with conventional C-arm fluoroscopy is needed to validate its benefits.
Purpose of the Study:
- To evaluate the perioperative and clinical advantages of intraoperative image-guided spinal navigation in ELSS.
- To compare its outcomes against conventional C-arm fluoroscopy.
Main Methods:
- Systematic literature search across major databases (PubMed, Scopus, etc.).
- Meta-analysis of 19 studies involving 1390 patients.
- Summarized outcomes using mean difference (MD) and standardized mean difference (SMD) with 95% confidence intervals.
Main Results:
- Image-guided navigation significantly reduced total operation time, puncture attempts, cannulation time, and hospital stay.
- It also led to lower fluoroscopy use and radiation exposure compared to C-arm fluoroscopy.
- No significant differences were found in back/leg pain (VAS) or disability (ODI) scores up to 1 year post-surgery.
Conclusions:
- Intraoperative image-guided spinal navigation significantly improves perioperative outcomes in ELSS.
- Clinical outcomes, such as pain and disability, were not significantly affected by the navigation method.
- Further research is needed to assess the cost-effectiveness of image-guided navigation in various healthcare settings.
