Navigation in minimally invasive spine surgery

Virk, Sohrab; Qureshi, Sheeraz A.

doi:10.21037/jss.2019.04.23

Cited by 63 publications

(48 citation statements)

References 20 publications

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“…35 Its effectiveness during MIS to allow surgeons greater understanding of bony and soft-tissue anatomy through limited incisions and exposure, as well as minimalizing radiation exposure, has been demonstrated. 23,36 Its unique contribution during MIS separation surgery lies in the abnormal anatomy inherent to tumoral invasion. 14,18,37 Thus, the use of guidance to identify the abnormal anatomy and determine the extent of resection is indispensable.…”

Section: Discussionmentioning

confidence: 99%

Separation surgery for metastatic epidural spinal cord compression: comparison of a minimally invasive versus open approach

Echt

Stock

Ramos

et al. 2021

Neurosurgical Focus

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OBJECTIVE The aim of this study was to compare outcomes of separation surgery for metastatic epidural spinal cord compression (MESCC) in patients undergoing minimally invasive surgery (MIS) versus open surgery. METHODS A retrospective study of patients undergoing MIS or standard open separation surgery for MESCC between 2009 and 2019 was performed. Both groups received circumferential decompression via laminectomy and a transpedicular approach for partial corpectomy to debulk ventral epidural disease, as well as instrumented stabilization. Outcomes were compared between the two groups. RESULTS There were 17 patients in the MIS group and 24 in the open surgery group. The average age of the MIS group was significantly older than the open surgery group (65.5 vs 56.6 years, p < 0.05). The preoperative Karnofsky Performance Scale score of the open group was significantly lower than that of the MIS group, with averages of 63.0% versus 75.9%, respectively (p = 0.02). This was also evidenced by the higher proportion of emergency procedures performed in the open group (9 of 24 patients vs 0 of 17 patients, p = 0.004). The average Spine Instability Neoplastic Score, number of levels fused, and operative parameters, including length of stay, were similar. The average estimated blood loss difference for the open surgery versus the MIS group (783 mL vs 430 mL, p < 0.05) was significant, although the average amount of packed red blood cells transfused was not significantly different (325 mL vs 216 mL, p = 0.39). Time until start of radiation therapy was slightly less in the MIS than the open surgery group (32.8 ± 15.6 days vs 43.1 ± 20.3 days, p = 0.069). Among patients who underwent open surgery with long-term follow-up, 20% were found to have local recurrence compared with 12.5% of patients treated with the MIS technique. No patients in either group developed hardware failure requiring revision surgery. CONCLUSIONS MIS for MESCC is a safe and effective approach for decompression and stabilization compared with standard open separation surgery, and it significantly reduced blood loss during surgery. Although there was a trend toward a faster time to starting radiation treatment in the MIS group, both groups received similar postoperative radiotherapy doses, with similar rates of local recurrence and hardware failure. An increased ability to perform MIS in emergency settings as well as larger, prospective studies are needed to determine the potential benefits of MIS over standard open separation surgery.

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Section: Discussionmentioning

confidence: 99%

Separation surgery for metastatic epidural spinal cord compression: comparison of a minimally invasive versus open approach

Echt

Stock

Ramos

et al. 2021

Neurosurgical Focus

View full text Add to dashboard Cite

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“…Virk et al discussed the benefits of navigation usage in MIS, particularly with the complex anatomy associated with placing C1-C2 instrumentation (30). The ability for the navigation systems to provide accurate real-time feedback is reliant on reference markers which vary from system to system.…”

Section: Navigation For Mismentioning

confidence: 99%

Current state of navigation in spine surgery

Rawicki¹,

Dowdell²,

Sandhu³

2021

Ann Transl Med

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The use of navigation has become more prevalent in spine surgery. The multitude of available platforms, as well as increased availability of navigation systems, have led to increased use worldwide. Specific subsets of spine surgeons have incorporated this new technology in their practices, including minimally invasive spine (MIS) spine surgeons, neurosurgeons, and high-volume surgeons. Improved accuracy with the use of navigation has been demonstrated and its use has proven to be a safe alternative to fluoroscopic guided procedures. Navigation use allows the limitation of radiation exposure to the surgeon during common spine procedures, which over the course of a surgeon's lifetime may offer significant health benefits. Navigation has also been beneficial in tumor resection and MIS surgery, where traditional anatomic landmarks are missing or in the case of MIS not visible. As cost effectiveness improves, the use of navigation is likely to continue to expand. Navigation will also continue to expand with further innovation such as coupling the use of navigation with robotics and improving tools to enhance the end user experience.

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“…Recently, the utility of computer-assisted orthopedic surgery (CAOS) has been widely reported [1,2]. This technology refers to approaches that use computerenabled simulations, tracking systems, or robotic devices to improve visibility of the surgical field and increase the surgical accuracy [3][4][5]. Evaluations of three-dimensional (3D) bone morphology, preoperative planning, and intraoperative navigation based on computer-aided technology are considered to be effective means to increase the accuracy of surgery and reduce complications.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional evaluations of preoperative planning reproducibility for the osteosynthesis of distal radius fractures

et al. 2021

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Background Three-dimensional preoperative planning was applied for the osteosynthesis of distal radius fractures. The objective of this study was to evaluate the reproducibility of three-dimensional preoperative planning for the osteosynthesis of distal radius fractures with three-dimensional reference points. Methods Sixty-three wrists of 63 distal radius fracture patients who underwent osteosynthesis with three-dimensional preoperative planning were evaluated. After taking preoperative CT scans of the injured wrists, 3D images of the distal radius were created. Fracture reduction, implants choices, and placements simulation were performed based on the 3D images. One month after the surgery, postoperative CT images were taken. The reproducibility was evaluated with preoperative plan and postoperative 3D images. The images were compared with the three-dimensional coordinates of radial styloid process, volar and dorsal edges of sigmoid notch, and the barycentric coordinates of the three reference points. The reproducibility of the preoperative plan was evaluated by the distance of the coordinates between the plan and postoperative images for the reference points. The reproducibility of radial inclination and volar tilt on three-dimensional images were evaluated by intra-class correlation coefficient (ICC). Results The distances between the preoperative plan and the postoperative reduction for each reference point were (1) 2.1±1.3 mm, (2) 1.9±1.2 mm, and (3) 1.9±1.2 mm, respectively. The distance between the preoperative plan and postoperative reduction for the barycentric coordinate was 1.3±0.8 mm. ICCs were 0.54 and 0.54 for the volar tilt and radial inclination, respectively (P<0.01). Conclusions Three-dimensional preoperative planning for the osteosynthesis of distal radius fracture was reproducible with an error of about 2 mm for each reference point and the correlations of reduction shapes were moderate. The analysis method and reference points may be helpful to understand the accuracy of reductions for the three-dimensional preoperative planning in the osteosynthesis of distal radius fractures. Trial registration Registered as NCT02909647 at ClinicalTrials.gov

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Navigation in minimally invasive spine surgery

Cited by 63 publications

References 20 publications

Separation surgery for metastatic epidural spinal cord compression: comparison of a minimally invasive versus open approach

Separation surgery for metastatic epidural spinal cord compression: comparison of a minimally invasive versus open approach

Current state of navigation in spine surgery

Three-dimensional evaluations of preoperative planning reproducibility for the osteosynthesis of distal radius fractures

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