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Updated: Jan 12, 2026
Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
Cone Beam Computed Tomography with Navigation Versus Computed Tomography with Navigation for Percutaneous Fixation of
Youssef Ghosn1, Amgad M Moussa1, Max Vaynrub2
1Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Purpose:
To assess the difference in procedure time, radiation dose, and pain outcome of percutaneous fixation by internal cemented screws (FICS) for pathologic fractures using cone beam computed tomography with navigation (CBCT-NAV) versus computed tomography with electromagnetic navigation (CT-NAV).
Materials And Methods:
This IRB-approved, single institution retrospective study included patients who underwent percutaneous FICS for pathologic fractures between 2020 and 2025. Radiation dose, procedure time, and pain outcomes were compared between two groups based on the navigation system used during the procedure (CBCT-NAV vs. CT-NAV). Dose parameters were converted to effective dose for comparison.
Results:
A total of 37 procedures (32 patients) were identified, 20 in the CBCT-NAV group and 17 in the CT-NAV group. No significant differences were found between groups regarding age, gender, body mass index, primary cancer type, fracture location, lesion size, number of screws placed per patient, ablation performed, cementoplasty performed, pain reduction, or immediate adverse events. No significant differences were observed for effective dose (33.3 ± 30.1 vs. 39.4 ± 25.7 mSv, respectively, p = 0.514). Significant differences were observed for procedural time (108.6 ± 47.9 vs. 228.8 ± 79.8 min, respectively, p < 0.001).
Conclusion:
CBCT navigation has a significantly lower procedural time compared to CT navigation for FCIS, with similar radiation dose and pain outcomes.
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