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Related Experiment Video

Updated: Jun 15, 2026

Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
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Impact of Navigation Modality on Radiographic Parameters Following Minimally Invasive Transforaminal Lumbar Interbody

Zora C Hahn1, Tomoyuki Asada1, Rebecca Boyle1

  • 1Department of Spine Surgery, Hospital for Special Surgery, New York, NY, USA.

Global Spine Journal
|March 10, 2026
PubMed
Summary
This summary is machine-generated.

Robotic guidance in minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) improved disc height restoration more than imaging-only navigation. Lumbar lordosis restoration was greater with imaging-only navigation, influenced by preoperative alignment.

Keywords:
disc heightlumbar lordosisminimally invasive transforaminal lumbar interbody fusionnavigationroboticsslip reductionspondylolisthesis

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Area of Science:

  • Spine Surgery
  • Orthopedic Technology
  • Surgical Navigation

Background:

  • Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is a common procedure for degenerative spondylolisthesis.
  • Robotic and imaging-only navigation systems offer different guidance approaches.
  • The impact of these modalities on radiographic outcomes requires detailed comparison.

Purpose of the Study:

  • To compare the radiographic outcomes of robotic-assisted versus imaging-only navigation in MI-TLIF.
  • To evaluate the influence of navigation modality on screw/cage characteristics, disc height, lumbar lordosis, and slip reduction.

Main Methods:

  • Retrospective cohort review of patients undergoing one-level MI-TLIF.
  • Comparison between robotic-assisted (Robo) and imaging-only navigation (Nav) groups.
  • Assessment of radiographic parameters preoperatively and 6 months postoperatively.

Main Results:

  • Robotic guidance was associated with greater disc height improvement (71.6% vs 22.5%, P=0.002).
  • Imaging-only navigation resulted in greater lumbar lordosis restoration (P=0.006).
  • Robotic group used larger screws; Nav group used wider cages. No significant differences in slip reduction or subsidence.

Conclusions:

  • Robotic navigation in MI-TLIF enhances disc height restoration and facilitates larger screw placement.
  • Lumbar lordosis restoration is primarily dependent on preoperative alignment and appears superior with image-guided navigation.
  • Both navigation modalities offer distinct advantages for optimizing specific radiographic goals in MI-TLIF.