Accuracy and Safety of Pedicle Screw Insertion Using Novel Intraoperative Computed Tomography Navigation System for...

Accurate pedicle screw placement is critical in spinal fusion surgery to prevent complications such as neurological and vascular injuries. While conventional intraoperative computed tomography (iCT) navigation systems enhance placement accuracy and reduce radiation exposure compared to fluoroscopic guidance, they can encounter line-of-sight issues that disrupt surgical workflows. The NextAR iCT navigation system aims to overcome these challenges by integrating an infrared camera directly onto surgical instruments, streamlining navigation and improving procedural efficiency.

This retrospective study evaluated the accuracy and safety of pedicle screw insertion using the NextAR navigation system in lumbar spinal fusion for degenerative diseases. We analyzed 307 screws using a CT-based grading system.

Among the 307 screws inserted, only 8 (2.6%) exhibited minor deviations (grade 1 or 2), with no severe perforations (grade 3 or 4). There were no neurological or vascular complications related to screw placement. The NextAR system enabled precise pedicle screw insertion without the need for fluoroscopic guidance, eliminating radiation exposure for the surgical team.

The NextAR navigation system demonstrated high accuracy and safety in pedicle screw placement for lumbar degenerative diseases. By addressing line-of-sight issues inherent in traditional navigation systems and eliminating intraoperative radiation exposure, it offers significant procedural advantages. Further randomized controlled trials are needed to compare its effectiveness with other advanced navigation systems.