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Intraoperative Cone-Beam Computed Tomography Navigation Versus 2-Dimensional Fluoroscopy in Single-Level Lumbar Spinal Fusion: A Comparative Analysis – Lumbar Fusion

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The article published in Neurospine in 2024 compared the outcomes of transpedicular screw placement using cone-beam computed tomography (CBCT) navigation versus conventional 2-dimensional fluoroscopy for patients with degenerative lumbar spondylolisthesis. The study found that CBCT navigation led to reduced screw placement time, operative time, and length of stay compared to 2D fluoroscopy, despite higher radiation exposure. The study included 30 patients and concluded that intraoperative CBCT navigation may be superior for single-level lumbar transpedicular screw fixation

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: This study suggests that intraoperative CBCT-navigated single-level lumbar transpedicular screw fixation is superior in terms of mean screw placement time, operative time, and LOS compared to 2D fluoroscopy, despite a higher intraoperative radiation exposure.

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Neurospine. 2024 Mar;21(1):76-82. doi: 10.14245/ns.2347106.553. Epub 2024 Mar 31. ABSTRACT OBJECTIVE: Several studies have advocated for the higher accuracy of transpedicular screw placement under cone-beam computed tomography (CBCT) compared to conventional 2-dimensional (2D) fluoroscopy. The superiority of navigation systems in perioperative and postoperative outcomes remains a topic of debate. This study aimed to compare operative,

Neurospine. 2024 Mar;21(1):76-82. doi: 10.14245/ns.2347106.553. Epub 2024 Mar 31.

ABSTRACT

OBJECTIVE: Several studies have advocated for the higher accuracy of transpedicular screw placement under cone-beam computed tomography (CBCT) compared to conventional 2-dimensional (2D) fluoroscopy. The superiority of navigation systems in perioperative and postoperative outcomes remains a topic of debate. This study aimed to compare operative time, screw placement time and accuracy, total radiation dose, perioperative and postoperative outcomes in patients who underwent transpedicular screw fixation for degenerative lumbar spondylolisthesis (DLS) using intraoperative CBCT navigation versus 2D fluoroscopy.

METHODS: A retrospective analysis was conducted on patients affected by single-level DLS who underwent posterior lumbar instrumentation with transpedicular screw fixation using surgical CBCT navigation (NV group) or 2D fluoroscopy-assisted freehand technique (FH group). Demographics, screw placement time and accuracy, operative time, total radiation dose, intraoperative blood loss, screw revision rate, complications, and length of stay (LOS) were assessed.

RESULTS: The study included a total of 30 patients (NV group: n = 15; FH group: n = 15). The mean screw placement time, operative time, and LOS were significantly reduced in the NV group compared to the FH group (p < 0.05). The total radiation dose was significantly higher in the NV group (p < 0.0001). No significant difference was found in terms of blood loss and postoperative complications.

: This study suggests that intraoperative CBCT-navigated single-level lumbar transpedicular screw fixation is superior in terms of mean screw placement time, operative time, and LOS compared to 2D fluoroscopy, despite a higher intraoperative radiation exposure.

PMID:38569632 | DOI:10.14245/ns.2347106.553

The London Spine Unit : the highest rated day surgery unit in London

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Intraoperative Cone-Beam Computed Tomography Navigation Versus 2-Dimensional Fluoroscopy in Single-Level Lumbar Spinal Fusion: A Comparative Analysis

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Neurospine. 2024 Mar;21(1):76-82. doi: 10.14245/ns.2347106.553. Epub 2024 Mar 31. ABSTRACT OBJECTIVE: Several studies have advocated for the higher accuracy of transpedicular screw placement under cone-beam computed tomography (CBCT) compared to conventional 2-dimensional (2D) fluoroscopy. The superiority of navigation systems in perioperative and postoperative outcomes remains a topic of debate. This study aimed to compare operative

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