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Trends and Outcomes of Computer-Assisted Navigation in Lumbar Spine Surgery: A National Database Analysis from 2010
Hannah Shelby1, Emily S Mills2, Andy Ton2
1Departments of Orthopedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles.
Study Design:
Database study.
Objective:
Given the high prevalence of degenerative lumbar pathologies, this study examines trends in computer-assisted navigation (CAN) utilization and complications in the top lumbar spine fusion procedures for degenerative conditions.
Summary Of Background Data:
Intraoperative CAN has advanced minimally invasive techniques and anatomic characterization. However, studies on the use of CAN in lumbar spine surgery remain limited.
Methods:
Patient data (2010-2021) was extracted from a national insurance database using ICD-9, ICD-10, and CPT codes. The top 5 lumbar degeneration codes were identified, and associated lumbar fusion CPT codes were used to create a cohort. Patients were stratified by procedures with and without CAN. Temporal and multivariable analyses were performed on postoperative complications at 90 days.
Results:
A total of 771,874 lumbar fusion patients (2010-2021) were identified in the PearlDiver database, of whom 14,354 (1.86%) involved CAN. CAN utilization increased significantly from 0.62% (371 patients) in 2010 to 4.48% (2998 patients) in 2021, a 623.82% increase. The most rapid growth occurred from 2017-2021 (+189.73%). Multivariable analysis linked CAN to lower odds of revision surgery (aOR=0.79; 95% CI: 0.58-0.87) but higher odds of DVT (aOR=1.42; 95% CI: 1.28-1.76).
Conclusion:
Computer-assisted navigation (CAN) utilization in lumbar fusion has risen significantly, particularly in recent years. Outcome analysis suggests an association with reduced revision rates but increased DVT risk.
