Advertisement

Computer Navigation in Minimally Invasive Spine Surgery

  • Jonathan N. SembranoEmail author
  • Sharon C. Yson
  • Jeffrey J. Theismann
Minimally Invasive Spine Surgery (W Hsu, Section Editor)
  • 13 Downloads
Part of the following topical collections:
  1. Topical Collection on Minimally Invasive Spine Surgery

Abstract

Purpose of Review

The goal of the review is to discuss the common general applications of navigation in the context of minimally invasive spine surgery and assess its value in the published literature comparing against non-navigated or navigated techniques.

Recent Findings

There is increasing utilization of computer navigation in minimally invasive spine surgery. There is synergy between navigation and minimally invasive technologies, such that one enhances or facilitates the other, thus leading to wider applications for both. Specifically, navigation has been shown to improve performance of percutaneous pedicle screw placement, vertebral augmentation, and minimally invasive fusion procedures. Overall, clinical studies have shown better accuracy and less radiation exposure with the use of navigation in spine surgery.

Summary

The use of navigation in minimally invasive spine surgery enhances the accuracy of instrumentation and decreases radiation exposure. It is yet to be determined whether patient-reported outcomes will differ. Further research on its effect on clinical outcomes may further define the future impact of navigation in minimally invasive spine surgery.

Keywords

Navigation Minimally invasive spine surgery Spine fusion Percutaneous pedicle screw 

Notes

Compliance with Ethical Standards

Conflict of interest

Jonathan N. Sembrano, MD has a research support from NuVasive, Inc. Sharon C. Yson, MD received a research support from SI-Bone, Inc. Jeffrey J. Theismann has no conflicts of interest.

Human and Animal Rights and Informed Consent

No human or animal studies were conducted by authors for this manuscript.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Rampersaud YR, Foley KT, Shen AC, Williams S, Solomito M. Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion. Spine (Phila Pa 1976). 2000;25(20):2637–45.CrossRefGoogle Scholar
  2. 2.
    Nakashima H, Sato K, Ando T, Inoh H, Nakamura H. Comparison of the percutaneous screw placement precision of isocentric C-arm 3-dimensional fluoroscopy-navigated pedicle screw implantation and conventional fluoroscopy method with minimally invasive surgery. J Spinal Disord Tech. 2009;22(7):468–72.CrossRefGoogle Scholar
  3. 3.
    Yang BP, Wahl MM, Idler CS. Percutaneous lumbar pedicle screw placement aided by computer-assisted fluoroscopy-based navigation: perioperative results of a prospective, comparative, multicenter study. Spine (Phila Pa 1976). 2012;37(24):2055–60.CrossRefGoogle Scholar
  4. 4.
    Bourgeois AC, Faulkner AR, Bradley YC, et al. Improved accuracy of minimally invasive transpedicular screw placement in the lumbar spine with 3-dimensional stereotactic image guidance: a comparative meta-analysis. J Spinal Disord Tech. 2015;28(9):324–9.CrossRefGoogle Scholar
  5. 5.
    Ohba T, Ebata S, Fujita K, Sato H, Haro H. Percutaneous pedicle screw placements: accuracy and rates of cranial facet joint violation using conventional fluoroscopy compared with intraoperative three-dimensional computed tomography computer navigation. Eur Spine J. 2016;25(6):1775–80.CrossRefGoogle Scholar
  6. 6.
    Innocenzi G, Bistazzoni S, D’Ercole M, Cardarelli G, Ricciardi F. Does navigation improve pedicle screw placement accuracy? Comparison between navigated and non-navigated percutaneous and open fixations. Acta Neurochir Suppl. 2017;124:289–95.CrossRefGoogle Scholar
  7. 7.
    Fomekong E, Pierrard J, Raftopoulos C. Comparative cohort study of percutaneous pedicle screw implantation without versus with navigation in patients undergoing surgery for degenerative lumbar disc disease. World Neurosurg. 2018;111:e410–7.CrossRefGoogle Scholar
  8. 8.
    Wood M, Mannion R. A comparison of CT-based navigation techniques for minimally invasive lumbar pedicle screw placement. J Spinal Disord Tech. 2011;24(1):E1–5.CrossRefGoogle Scholar
  9. 9.
    Santos ER, Sembrano JN, Yson SC, Polly DW Jr. Comparison of open and percutaneous lumbar pedicle screw revision rate using 3-D image guidance and intraoperative CT. Orthopedics. 2015;38(2):e129–34.CrossRefGoogle Scholar
  10. 10.
    Yson SC, Sembrano JN, Sanders PC, Santos ER, Ledonio CG, Polly DW Jr. Comparison of cranial facet joint violation rates between open and percutaneous pedicle screw placement using intraoperative 3-D CT (O-arm) computer navigation. Spine (Phila Pa 1976). 2013;38(4):E251–8.CrossRefGoogle Scholar
  11. 11.
    Tian W, Xu Y, Liu B, et al. Lumbar spine superior-level facet joint violations: percutaneous versus open pedicle screw insertion using intraoperative 3-dimensional computer-assisted navigation. Chin Med J. 2014;127(22):3852–6.PubMedGoogle Scholar
  12. 12.
    von Jako R, Finn MA, Yonemura KS, et al. Minimally invasive percutaneous transpedicular screw fixation: increased accuracy and reduced radiation exposure by means of a novel electromagnetic navigation system. Acta Neurochir. 2011;153(3):589–96.CrossRefGoogle Scholar
  13. 13.
    Villavicencio AT, Burneikiene S, Bulsara KR, Thramann JJ. Intraoperative three-dimensional fluoroscopy-based computerized tomography guidance for percutaneous kyphoplasty. Neurosurg Focus. 2005;18(3):e3.CrossRefGoogle Scholar
  14. 14.
    Izadpanah K, Konrad G, Sudkamp NP, Oberst M. Computer navigation in balloon kyphoplasty reduces the intraoperative radiation exposure. Spine (Phila Pa 1976). 2009;34(12):1325–9.CrossRefGoogle Scholar
  15. 15.
    Sun CT, Zhao LL, Zhang QW, Wen LY, Zhang HC. Navigation techniques assisted kyphoplasty for the treatment of osteoporotic spinal compression fracture. Chin Med J. 2009;122(8):987–9.PubMedGoogle Scholar
  16. 16.
    Sembrano JN, Yson SC, Polly DW Jr, Ledonio CG, Nuckley DJ, Santos ER. Comparison of nonnavigated and 3-dimensional image-based computer navigated balloon kyphoplasty. Orthopedics. 2015;38(1):17–23.CrossRefGoogle Scholar
  17. 17.
    Kim CW, Lee YP, Taylor W, Oygar A, Kim WK. Use of navigation-assisted fluoroscopy to decrease radiation exposure during minimally invasive spine surgery. Spine J. 2008;8(4):584–90.CrossRefGoogle Scholar
  18. 18.
    Luo W, Zhang F, Liu T, Du XL, Chen AM, Li F. Minimally invasive transforaminal lumbar interbody fusion aided with computer-assisted spinal navigation system combined with electromyography monitoring. Chin Med J. 2012;125(22):3947–51.PubMedGoogle Scholar
  19. 19.
    Cho JY, Chan CK, Lee SH, Lee HY. The accuracy of 3D image navigation with a cutaneously fixed dynamic reference frame in minimally invasive transforaminal lumbar interbody fusion. Comput Aided Surg. 2012;17(6):300–9.CrossRefGoogle Scholar
  20. 20.
    Zhang Y, Xu C, Zhou Y, Huang B. Minimally invasive computer navigation-assisted endoscopic transforaminal interbody fusion with bilateral decompression via a unilateral approach: initial clinical experience at one-year follow-up. World Neurosurg. 2017;106:291–9.CrossRefGoogle Scholar
  21. 21.
    Tian W, Xu YF, Liu B, et al. Computer-assisted minimally invasive transforaminal lumbar interbody fusion may be better than open surgery for treating degenerative lumbar disease. Clin Spine Surg. 2017;30(6):237–42.CrossRefGoogle Scholar
  22. 22.
    Xu YF, Le XF, Tian W, et al. Computer-assisted, minimally invasive transforaminal lumbar interbody fusion: one surgeon’s learning curve A STROBE-compliant article. Medicine (Baltimore). 2018;97(27):e11423.CrossRefGoogle Scholar
  23. 23.
    Park P. Three-dimensional computed tomography-based spinal navigation in minimally invasive lateral lumbar interbody fusion: feasibility, technique, and initial results. Neurosurgery. 2015;11(Suppl 2):259–67.CrossRefGoogle Scholar
  24. 24.
    Jiang J, Gan F, Tan H, et al. Effect of computer navigation-assisted minimally invasive direct lateral interbody fusion in the treatment of patients with lumbar tuberculosis: a retrospective study. Medicine (Baltimore). 2018;97(48):e13484.CrossRefGoogle Scholar
  25. 25.
    Zhang YH, White I, Potts E, Mobasser JP, Chou D. Comparison perioperative factors during minimally invasive pre-psoas lateral interbody fusion of the lumbar spine using either navigation or conventional fluoroscopy. Global Spine J. 2017;7(7):657–63.CrossRefGoogle Scholar
  26. 26.
    DiGiorgio AM, Edwards CS, Virk MS, Mummaneni PV, Chou D. Stereotactic navigation for the prepsoas oblique lateral lumbar interbody fusion: technical note and case series. Neurosurg Focus. 2017;43(2):E14.CrossRefGoogle Scholar
  27. 27.
    Sellin JN, Mayer RR, Hoffman M, Ropper AE. Simultaneous lateral interbody fusion and pedicle screws (SLIPS) with CT-guided navigation. Clin Neurol Neurosurg. 2018;175:91–7.CrossRefGoogle Scholar
  28. 28.
    Gianaris TJ, Helbig GM, Horn EM. Percutaneous pedicle screw placement with computer-navigated mapping in place of Kirschner wires: clinical article. J Neurosurg Spine. 2013;19(5):608–13.CrossRefGoogle Scholar
  29. 29.
    Kim TT, Drazin D, Shweikeh F, Pashman R, Johnson JP. Clinical and radiographic outcomes of minimally invasive percutaneous pedicle screw placement with intraoperative CT (O-arm) image guidance navigation. Neurosurg Focus. 2014;36(3):E1.CrossRefGoogle Scholar
  30. 30.
    Tam AL, Mohamed A, Pfister M, et al. C-arm cone beam computed tomography needle path overlay for fluoroscopic guided vertebroplasty. Spine (Phila Pa 1976). 2010;35(10):1095–9.CrossRefGoogle Scholar
  31. 31.
    Schils F. O-arm-guided balloon kyphoplasty: prospective single-center case series of 54 consecutive patients. Neurosurgery. 2011;68(2 Suppl Operative):ons250–6 discussion 256.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Jonathan N. Sembrano
    • 1
    Email author
  • Sharon C. Yson
    • 1
  • Jeffrey J. Theismann
    • 1
  1. 1.Department of Orthopaedic SurgeryUniversity of Minnesota Medical SchoolMinneapolisUSA

Personalised recommendations