Reduction of Radiation Exposure by the Use of Fluoroscopic Guidance in Transpedicular Instrumentation

Commentary: Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: Case Series With an Operative Video Using Fluoroscopy-Based Instrument Tracking Guidance

“…Furthermore, Merloz et al 11 investigated the outcomes of the 2-dimensional (2D) fluoroscopy navigation system using a 3-dimensional (3D) optical localizer (Polaris system, Northern Digital) for surgical instrumentation tracking during pedicle screw insertion and found less radiation exposure and shorter operative times compared with conventional surgery. Hart et al 12 demonstrated similar findings using a CT-free 2D fluoroscopic guidance system, VectorVision (Brain LAB), reporting that an average of 2 screw placements per vertebra took 3.4 seconds compared with 14.4 seconds for conventional methods. When compared with intraoperative CT navigation for lateral single-position surgery, Hiyama et al 13 found no differences in accuracy of percutaneous pedicle screw insertion between groups, as well as decreased mean odds ratio duration in the fluoroscopy group.…”