Image-guided spine surgery: state of the art and future directions
- 11 September 2009
- journal article
- review article
- Published by Springer Science and Business Media LLC in European Spine Journal
- Vol. 19 (1), 25-45
- https://doi.org/10.1007/s00586-009-1091-9
Abstract
Navigation technology is a widely available tool in spine surgery and has become a part of clinical routine in many centers. The issue of where and when navigation technology should be used is still an issue of debate. It is the aim of this study to give an overview on the current knowledge concerning the technical capabilities of image-guided approaches and to discuss possible future directions of research and implementation of this technique. Based on a Medline search total of 1,462 publications published until October 2008 were retrieved. The abstracts were scanned manually for relevance to the topics of navigated spine surgery in the cervical spine, the thoracic spine, the lumbar spine, as well as ventral spine surgery, radiation exposure, tumor surgery and cost-effectivity in navigated spine surgery. Papers not contributing to these subjects were deleted resulting in 276 papers that were included in the analysis. Image-guided approaches have been investigated and partially implemented into clinical routine in virtually any field of spine surgery. However, the data available is mostly limited to small clinical series, case reports or retrospective studies. Only two RCTs and one metaanalysis have been retrieved. Concerning the most popular application of image-guided approaches, pedicle screw insertion, the evidence of clinical benefit in the most critical areas, e.g. the thoracic spine, is still lacking. In many other areas of spine surgery, e.g. ventral spine surgery or tumor surgery, image-guided approaches are still in an experimental stage. The technical development of image-guided techniques has reached a high level as the accuracies that can be achieved technically meet the anatomical demands. However, there is evidence that the interaction between the surgeon (‘human factor’) and the navigation system is a source of inaccuracy. It is concluded that more effort needs to be spend to understand this interaction.Keywords
This publication has 117 references indexed in Scilit:
- The Effect of Parallax on Intraoperative Positioning of the Charité Artificial DiscJournal of Spinal Disorders & Techniques, 2008
- Comparison of two novel fluoroscopy-based stereotactic methods for cervical pedicle screw placement and review of the literatureEuropean Spine Journal, 2008
- Navigated pedicle screw placement: Experimental comparison between CT- and 3D fluoroscopy-based techniquesComputer Aided Surgery, 2008
- Revision cervical spine surgery using transarticular or pedicle screws under a computer-assisted image-guidance systemJournal of Orthopaedic Science, 2005
- The use of virtual fluoroscopy in managing acute type II odontoid fracture with anterior single-screw fixation. A safe, effective, elegant and fast form of treatmentActa Neurochirurgica, 2005
- Computer-Guided Percutaneous Interbody Fixation and Fusion of the L5-S1 DiscJournal of Spinal Disorders & Techniques, 2005
- Endoscope-based hybrid navigation system for minimally invasive ventral spine surgeriesComputer Aided Surgery, 2005
- Spinal navigation in cervical fractures?A preliminary clinical study on Judet-osteosynthesis of the axisComputer Aided Surgery, 2001
- Accuracy of pedicle screw insertion with and without computer assistance: a randomised controlled clinical study in 100 consecutive patientsEuropean Spine Journal, 2000
- Coding of modified body schema during tool use by macaque postcentral neuronesNeuroReport, 1996