Computer-assisted navigation improves lumbar vertebral body drilling accuracy in dogs

To evaluate the accuracy of computer-assisted navigation compared with a freehand technique for bicortical lumbar vertebral body drilling in canine cadavers.

This was a randomized cadaveric experimental study using canine lumbar spines (n = 9). Two surgeons performed bicortical lumbar vertebral body drilling with navigated and freehand techniques on randomly assigned cadavers. Drill trajectories were independently assessed by 4 blinded veterinary surgeons using the modified Zdichavsky classification, where grade I represented optimal placement and grade ≥ III indicated clinically relevant cortical breach.

A total of 108 lumbar vertebral body drill trajectories were evaluated: 54 navigated and 54 freehand. Navigated drilling resulted in a significantly higher proportion of optimal trajectories compared with freehand drilling (92.6% vs 42.6%; OR, 16.85; 95% CI, 5.68 to 47.22; P < .0001). Clinically relevant breaches occurred significantly less frequently with navigation (3.7% vs 35.2%; OR, 0.071; 95% CI, 0.016 to 0.283; P < .0001), representing an 89% relative reduction. Statistically significant improvements in accuracy were observed in both small (< 15 kg) and large (15 to 30 kg) dogs.

Computer-assisted navigation significantly improves the accuracy of bicortical lumbar vertebral body drilling in canine cadavers and markedly reduces the incidence of clinically relevant cortical breaches compared with a freehand technique.

Computer-assisted navigation can enhance safety during canine spinal procedures, particularly bicortical drilling. Improved accuracy observed across body sizes suggests that navigation may be beneficial in canine patients where the vertebral body corridor is narrow and the margin for error is limited.