Image Guidance in Minimally Invasive Spine Surgery

  • Ryan B. Kochanski
  • Hussein Alahmadi
  • John E. O’TooleEmail author


Image guidance (IG) can serve as a very important adjunct to the surgeon during minimally invasive spine surgery (MISS). There is robust data showing that IG decreases the incidence of suboptimal screw placement and more recent data that IG may decrease the incidence of neurological complications and need for reoperations following thoracolumbar instrumentation while improving workflow. IG is invaluable in cases of severe deformity or other altered anatomy as well as for the intraoperative training of residents and fellows. Indications for its use continue to expand with a growing body of literature justifying its use in not only guiding thoracolumbar pedicle screw placement but also cervical and pelvic instrumentation as well as spinal tumor resection. IG offers the further benefit of minimizing occupational exposures to ionizing radiation for the surgeon and OR staff. Future studies will help to modify imaging protocols in IG to also minimize patients’ radiation exposure.

As the use of IG in spine surgery continues to expand, its value in improving surgical accuracy and clinical outcomes must be weighed against concerns over cost and radiation exposure. Our personal experience has shown the technology to be both efficient and cost-effective by reducing screw revision rates and reducing occupational radiation exposures. Further research will continue to clarify the answers to these questions and better delineate situations where IG may be particularly beneficial in spine surgery.


Image guidance Intraoperative CT Navigation Radiation exposure Stereotaxy 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ryan B. Kochanski
    • 1
  • Hussein Alahmadi
    • 2
  • John E. O’Toole
    • 1
    Email author
  1. 1.Department of NeurosurgeryRush University Medical CenterChicagoUSA
  2. 2.Department of NeurosurgeryHartford Healthcare Medical GroupNew BritainUSA

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