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O-Arm Navigation Enhances Facet Preservation Without Compromising Clinical Outcomes in UBE Decompression for
Yi Liu1,2,3, Yiwei Xie1,2,3, Zhibao Chen1,2,3
1Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Orthopaedic Surgery
|May 8, 2026
Summary
O-arm navigation for unilateral biportal endoscopic decompression in adult degenerative scoliosis (ADS) offers better facet preservation and control. This technique achieves similar symptom relief to conventional methods while minimizing instability risks.
Area of Science:
- Spine surgery
- Minimally invasive spine surgery
- Adult degenerative scoliosis
Background:
- Unilateral biportal endoscopic (UBE) decompression is effective for stable adult degenerative scoliosis (ADS).
- Challenges exist in achieving adequate decompression without excessive facetectomy in complex spinal anatomy.
- Intraoperative O-arm navigation may improve UBE procedural accuracy.
Purpose of the Study:
- To compare clinical outcomes and radiological parameters of O-arm navigation-assisted UBE decompression versus conventional fluoroscopy-guided UBE decompression in stable ADS.
- To evaluate the impact of O-arm navigation on facet preservation and segmental stability.
Main Methods:
- Retrospective study of 63 patients with stable ADS undergoing UBE decompression alone (2021-2023).
- Comparison between O-arm navigation (NAV, n=34) and non-navigation (NON-NAV, n=29) groups.
- Primary endpoint: Facet preservation rate (FPR) at 1 month via CT volumetry; secondary endpoints included DCSA, stability, and patient-reported outcomes (VAS/ODI).
Main Results:
- Both groups showed significant improvement in pain (VAS) and function (ODI) without between-group differences.
- O-arm navigation demonstrated a higher facet preservation rate and smaller segmental perturbations (dynamic angulation, slip).
- DCSA increased similarly in both groups, but with less dispersion in the NAV group, indicating more uniform decompression.
Conclusions:
- O-arm navigation for UBE decompression in stable ADS did not increase operative time or blood loss.
- It provided tighter control of decompression, enhanced facet preservation, and reduced segmental instability compared to conventional methods.
- The navigation technique enables precise decompression while preserving spinal stability.
