Outcomes In Navigated Spinal Surgery

This chapter reviews the major outcomes observed in modern spine surgery using navigated technologies. The aim of this chapter is to critically analyze current radiographic, clinical, surgical, patient-reported, and financial outcomes in computer-assisted navigated spine surgery compared with conventional fluoroscopic techniques. Another chapter will describe outcomes in robotic spine surgery. Navigation in spine surgery may be considered as an adjunct for optimizing surgical outcomes. However, a firm understanding of the anatomy and surgical skills needed for more conventional techniques remains important to the modern spine surgeon. Pedicle screw insertion with navigation has largely been shown to be more accurate and requires less time than conventional freehand techniques. Navigated spinal surgery decreases radiation exposure to the surgical team. Operative times in navigated spine surgery have shown noninferiority metrics when compared to conventional methods. Perioperative complications and patient-reported outcomes may require additional studies to better understand the complex interaction of navigation techniques and associated outcomes. Early comparative studies indicate less blood loss and the potential for decreased neurovascular intraoperative complications resulting from more accurate instrumentation placement. Some of the limitations and challenges seen in navigated spine surgery include high acquisition costs of the equipment, the learning curve for surgeon and healthcare team, and unique risks associated with the technology.