Impact of Navigation Assistance on Perioperative Outcomes in Sacroiliac Joint Arthrodesis: A Comparative Study

Background Navigation systems are increasingly applied to enhance precision and reduce radiation exposure in sacroiliac joint (SIJ) arthrodesis. However, evidence comparing navigated and conventional procedures remains limited. This study evaluated perioperative outcomes of navigation-assisted versus non-navigated SIJ arthrodesis using the DIANA implant system (Signus GmbH, Alzenau, Germany). Methods A retrospective comparative study was conducted on 30 patients who underwent SIJ arthrodesis between 2011 and 2021 at the Department of Neurosurgery, Hospital of the Order of Merciful Brothers, Regensburg, Germany. Thirteen patients received navigation-assisted surgery and 17 underwent conventional fluoroscopy-guided procedures. Perioperative parameters assessed included operative time, radiation dose, fluoroscopy time, and intraoperative blood loss. Group comparisons were performed using independent-samples t-tests and one-way ANOVA, with significance set at p < 0.05. Results Baseline characteristics (age, sex, BMI) were comparable between groups. Mean operative time was slightly shorter with navigation (146 ± 37 min) versus non-navigated procedures (162 ± 31 min; p = 0.198). Radiation dose was lower in the navigation group (718 ± 379 mGy·cm² vs 1015 ± 532 mGy·cm²; p = 0.100), though not statistically significant. Fluoroscopy time was significantly reduced with navigation (82 ± 40 s vs 112 ± 34 s; p = 0.037). Blood loss was similar between groups (246 ± 125 mL vs 238 ± 110 mL; p = 0.855). Conclusion Navigation in SIJ arthrodesis significantly decreases fluoroscopy time while maintaining similar operative duration, radiation dose, and blood loss compared to conventional techniques. Its main advantage lies in improving imaging efficiency and workflow precision. Larger prospective studies are warranted to validate these findings and assess long-term clinical outcomes.