The Use of Computerized Image Guidance in Lumbar Disk Arthroplasty

Department

neurosurgery

Document Type

Article

Abstract

OBJECTIVES: Surgical navigation systems have been increasingly studied and applied in the application of spinal instrumentation. Successful disk arthroplasty requires accurate midline and rotational positioning for optimal function and longevity. A surgical simulation study in human cadaver specimens was done to evaluate and compare the accuracy of standard fluoroscopy, computer-assisted fluoroscopic image guidance, and Iso-C image guidance in the placement of lumbar intervertebral disk replacements. METHODS: Lumbar intervertebral disk prostheses were placed using three different image guidance techniques in three human cadaver spine specimens at multiple levels. Postinstrumentation accuracy was assessed with thin-cut computed tomography scans. RESULTS: Intervertebral disk replacements placed using the StealthStation with Iso-C were more accurately centered than those placed using the StealthStation with FluoroNav and standard fluoroscopy. Intervertebral disk replacements placed with Iso-C and FluoroNav had improved rotational divergence compared with standard fluoroscopy. Iso-C and FluoroNav had a smaller interprocedure variance than standard fluoroscopy. These results did not approach statistical significance. Relative to both virtual and standard fluoroscopy, use of the StealthStation with Iso-C resulted in improved accuracy in centering the lumbar disk prosthesis in the coronal midline. CONCLUSIONS: The StealthStation with FluoroNav appears to be at least equivalent to standard fluoroscopy and may offer improved accuracy with rotational alignment while minimizing radiation exposure to the surgeon. Surgical guidance systems may offer improved accuracy and less interprocedure variation in the placement of intervertebral disk replacements than standard fluoroscopy. Further study regarding surgical navigation systems for intervertebral disk replacement is warranted. Copyright © 2006 by Lippincott Williams & Wilkins.

Publication Date

2006

Publication Title

Journal of Spinal Disorders and Techniques

ISSN

1536-0652

Volume

19

Issue

1

First Page

22

Last Page

27

Digital Object Identifier (DOI)

10.1097/01.bsd.0000187977.76926.85

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