Spine Surgery and Related Research最新文献

{"title":"Outcomes after Cortical Bone Trajectory Screw versus Traditional Pedicle Screw in Single-Level Lumbar Spine Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Muhammad Talal Ibrahim, Cole Veliky, Elizabeth Yu","doi":"10.22603/ssrr.2024-0292","DOIUrl":"10.22603/ssrr.2024-0292","url":null,"abstract":"<p><strong>Background: </strong>Cortical bone trajectory screw (CBTS) is reported to offer increased cortical bone purchase and improved outcomes as compared to the traditional pedicle screw (PS), particularly in osteoporotic patients. The systematic review aims to compare randomized controlled trials comparing CBTS with PS in single-level lumbar spine fusion surgery.</p><p><strong>Methods: </strong>A systematic search was conducted on PubMed (MEDLINE), Scopus, Embase, Web of Science, and Cochrane. Moreover, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), and China National Knowledge Infrastructure (CNKI) were also searched. Outcome measures included fusion rates, complication rates, perioperative parameters, pain scores, and functionality. (PROSPERO: CRD42024523809).</p><p><strong>Results: </strong>Four manuscripts, reporting on three randomized controlled trials (RCTs) and 416 patients, were included in this review. The follow-up ranged from 24 to 26 months postoperatively. All patients underwent single-level fusion only. There was no significant difference in the fusion rates between CBTS and PS at one-year (risk ratio [RR] 1.05 [0.97, 1.13], p=0.24) or two-year (RR 1.02 [0.96, 1.08], p=0.47) follow-ups. The CBTS group had a lower risk of intraoperative complications (RR 0.44 [0.32, 0.60], p<0.001) but an equal risk of postoperative complications (RR 0.71 [0.42, 1.22], p=0.22). There was no difference in pain, functionality, disability, and quality-of-life scores. CBTS group had better outcomes in incision length (mean difference [MD] -25.44 [-40.76, -10.12], p=0.001), operative time (MD -20.71 [-32.91, -8.51], p=0.009), and blood loss (MD -60.23 [-106.74, -13.72], p=0.01), while there was no difference in length of stay (MD -0.49 [-1.01, 0.04], p=0.07).</p><p><strong>Conclusions: </strong>Although slightly favoring CBTS, RCTs were limited in number and had a serious risk of bias. Future RCTs should use superiority trial designs, have minimal bias, and include implant details, incidence of adjacent segment disease, and quality-of-life metrics.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"289-299"},"PeriodicalIF":1.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation the Efficiency of Braces for Degenerative Scoliosis: A Systematic Review of Literature.","authors":"Mohammad Taghi Karimi, Parvaneh Bazipour","doi":"10.22603/ssrr.2024-0162","DOIUrl":"10.22603/ssrr.2024-0162","url":null,"abstract":"<p><strong>Background: </strong>Degenerative scoliosis is a progressive side-to-side deformity of the spine that is common in mature individuals, characterized by a Cobb angle of >10°. Current treatment options vary and can be categorized as conservative or non-conservative (surgery), with the primary goal of pain reduction. However, there is conflicting evidence regarding which treatment option is most effective. The aim of this study was to determine the effectiveness of braces in this group of subjects.</p><p><strong>Methods: </strong>A systematic search was conducted in databases including PubMed, Web of Science, Scopus, and Embase for the period between 1950 and 2024. Keywords used were: (degenerative scoliosis OR adult scoliosis) AND (conservative treatment OR brace OR orthosis). The quality of the selected studies was evaluated using the Downs and Black tool.</p><p><strong>Results: </strong>Of 500 papers identified in the search, a total of 11 studies were chosen for final analysis. Most of the selected studies focused on the effects of various types of braces on pain intensity, quality of life, and functional performance in subjects with degenerative scoliosis.</p><p><strong>Conclusions: </strong>Based on the available literature and the lack of strong studies on the effectiveness of braces, it cannot be definitively concluded that the use of braces reduces the severity of scoliosis curves in adults with degenerative scoliosis. However, braces may have an impact on quality of life and pain severity in this group of subjects.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"283-288"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answer to the Letter to the Editor from Hinpetch Daungsupawong Concerning \"Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models\".","authors":"Takahiro Ogawa, Masatoshi Morimoto, Shutaro Fujimoto, Masaru Tominaga, Yasuyuki Omichi, Kosuke Sugiura, Fumitake Tezuka, Kazuta Yamashita, Koichi Sairyo","doi":"10.22603/ssrr.2025-0009","DOIUrl":"10.22603/ssrr.2025-0009","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"390-391"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of New Surgical Training for Full Endoscopic Surgery Using 3D-Printed Models.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.22603/ssrr.2024-0323","DOIUrl":"10.22603/ssrr.2024-0323","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"388-389"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Spondylolysis Repair Using Headless Compression Screws with a Cortical Bone Trajectory: A Technical Description and Case Series.","authors":"Naoki Aoyama, Katsuhito Kiyasu, Ryuichi Takemasa, Nobuaki Tadokoro, Shuhei Mizobuchi, Masahiko Ikeuchi","doi":"10.22603/ssrr.2024-0262","DOIUrl":"10.22603/ssrr.2024-0262","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar spondylolysis (LS) is a stress fracture of the pars interarticularis that can occur in adolescents. Both early- and progressive-stage LS can be successfully treated with conservative therapy consisting of activity modification and external bracing; however, conservative therapy is not suitable for athletes who hope for an early return to sports. We introduce a novel, minimally invasive surgical technique for the treatment of LS that enables an early return to sports and describe surgical results, including bone union rates, time of both bone unions, and return to sports.</p><p><strong>Technical note: </strong>To facilitate an early return to sports in adolescent athletes with early-to-progressive-stage LS, we developed a percutaneous spondylolysis repair technique using cannulated compression headless screws with a cortical bone trajectory. Fourteen adolescent athletes underwent this technique; as a result, all athletes achieved bone union and returned to sports within 3 months.</p><p><strong>Conclusions: </strong>This minimally invasive surgical technique for LS can achieve early bone union in adolescent athletes, thereby facilitating an early return to sports.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"375-380"},"PeriodicalIF":1.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort.","authors":"Shunsuke Ohira, Yukimasa Yamato, Yuki Taniguchi, Naohiro Kawamura, Tetsusai Iizuka, Akiro Higashikawa, Naoto Komatsu, Yujiro Takeshita, Keiichiro Tozawa, Masayoshi Fukushima, Daiki Urayama, Takashi Ono, Nobuhiro Hara, Kazuhiro Masuda, Seiichi Azuma, Hiroki Iwai, Masahito Oshina, Shurei Sugita, Shima Hirai, Katsuyuki Sasaki, Hiroyuki Nakarai, Nozomu Ohtomo, Hideki Nakamoto, So Kato, Yoshitaka Matsubayashi, Sakae Tanaka, Yasushi Oshima","doi":"10.22603/ssrr.2024-0225","DOIUrl":"10.22603/ssrr.2024-0225","url":null,"abstract":"<p><strong>Introduction: </strong>Despite an increase in the demand for surgical treatment of elderly patients with degenerative spinal disorders, little is known about mortality following spinal surgery in this population. This study aims to identify the incidence and causes of in-hospital mortality in elderly patients after elective spine surgery.</p><p><strong>Methods: </strong>We extracted the data of patients aged ≥65 years who underwent elective spine surgery between December 12, 2016, and May 31, 2022, from our prospective multicenter cohort. The primary outcome was the in-hospital mortality rate. Univariate analysis was conducted to identify potential risk factors for postoperative mortality. The detailed clinical course of patients who died was retrospectively investigated using medical records.</p><p><strong>Results: </strong>A total of 10,976 eligible patients (5,976 males and 5,000 females), with a mean age of 75.5 years, were identified. There were eight in-hospital deaths (0.07%). Univariate analyses showed that the eight patients were significantly older (82.1 years vs. 75.5 years, P=0.008), were more frequently hemodialysis-dependent (50.0% vs. 2.9%, P<0.001), and had a higher proportion of cases with cervical surgery (62.5% vs. 17.0%, P<0.001) and preoperative American Society of Anesthesiologists Physical Status ≥3 (87.5% vs. 14.6%, P<0.001). Death occurred at a median of 24.5 days postoperatively. The causes of in-hospital death were as follows: gastrointestinal diseases in five cases (ischemic colitis in three cases, panperitonitis in one, and intestinal perforation in one), sepsis due to unknown causes in two, and lethal arrhythmia in one. The initial symptoms preceding the lethal clinical course were mainly common gastrointestinal symptoms, such as abdominal pain, anorexia, diarrhea, and vomiting.</p><p><strong>Conclusions: </strong>The main cause of in-hospital mortality was gastrointestinal disease. Surgeons should be aware that common gastrointestinal symptoms can be the initial symptoms of a subsequent lethal clinical course in elderly patients.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"331-338"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biportal Endoscopic Spinal Surgery for Posterior Decompression of Thoracic Myelopathy Caused by Single-level Thoracic Ossification of the Ligamentum Flavum.","authors":"Zhuolin Zhong, Jingjing Ying, Hongwei Wu, Shaohua Zhang, Mingshuai Ying, Qingfeng Hu","doi":"10.22603/ssrr.2024-0094","DOIUrl":"10.22603/ssrr.2024-0094","url":null,"abstract":"<p><strong>Introduction: </strong>Thoracic ossification of the ligamentum flavum (T-OLF), which leads to neurological impairment, is a rare pathologic entity. Open posterior laminectomy is the gold standard treatment for T-OLF. However, the high rates of postoperative complications and perioperative morbidity have raised many concerns among surgeons. This study presented a series of patients with symptomatic single-level T-OLF who underwent posterior decompression using biportal endoscopic spinal surgery (BESS). The objective of this study was to demonstrate our procedure using BESS for T-OLF resection and to evaluate its safety and efficacy.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who previously underwent thoracic posterior decompression with BESS between February 2021 and March 2023. Neurological status was assessed using the revised Japanese Orthopedic Association (JOA) score for thoracic myelopathy before surgery and at the final follow-up, along with the recovery rate (RR) at the final follow-up. The radiological outcome was evaluated by measuring the cross-sectional area (CSA) of the spinal canal from the T2 axial images at the most stenotic level, before and after surgery.</p><p><strong>Results: </strong>Twenty patients (8 male and 12 female; aged between 38 and 79 years) were enrolled in this study. The mean operation time was 89.7±21.8 min. The average JOA score was 5.6±1.1 before surgery and 9.1±1.0 at the final follow-up. The average RR at the final follow-up was 65.6%. Outcomes were classified as excellent in six patients (30.0%), good in nine patients (45.0%), and moderate in five patients (25.0%), with no cases categorized as fair or worsened (0%). The mean preoperative and postoperative CSA were 0.92±0.14 cm² and 1.38±0.22 cm², respectively.</p><p><strong>Conclusions: </strong>BESS is a safe, effective, and minimally invasive alternative to conventional open surgery for single-level T-OLF.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"321-330"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study.","authors":"Takashi Hirai, Takuya Takahashi, Yohei Takahashi, Kota Watanabe, Tomohiro Banno, Kyohei Sakaki, Yoshiyasu Arai, Yuichi Takano, Yawara Eguchi, Yuki Taniguchi, Satoshi Maki, Yasuchika Aoki, Shunichi Fujii, Kentaro Sakaeda, Yu Matsukura, Tsutomu Akazawa, Akihito Minamide, Hidetoshi Nojiri, Kenichiro Sakai, Satoshi Kato, Koji Tamai, Hidekazu Suzuki, Masayuki Miyagi, Hiroyuki Sato, Toshitaka Yoshii, Hiroshi Yamada, Takashi Kaito, Yutaka Hiraizumi, Masatsune Yamagata, Masaya Nakamura, Akihiro Hirakawa, Naofumi Hosogane, Seiji Ohtori","doi":"10.22603/ssrr.2024-0288","DOIUrl":"10.22603/ssrr.2024-0288","url":null,"abstract":"<p><strong>Introduction: </strong>Chemonucleolysis with condoliase (chondroitin sulfate ABC endolyase) has been widely employed to treat patients with lumbar disc herniation (LDH) in Japan. Although it is an effective and relatively safe treatment for radicular neuropathy in patients with LDH, there have been no reports that investigate how severe low back pain (LBP) changes after condoliase injection. In this multicenter study, the effectiveness of condoliase injection for reducing severe LBP in patients with LDH was evaluated.</p><p><strong>Methods: </strong>This retrospective study involved patients treated with intradiscal condoliase injection for LDH at nine participating centers. Patients were diagnosed with subligamentous-type herniation based on pretreatment MRI. Patients with severe LBP (defined as a preinjection numeric rating scale [NRS] for LBP greater than or equal to that for leg pain) were categorized into the LBP group. Demographic data, adverse events, treatment costs, and the NRS for LBP and lower extremity pain were analyzed. A 50% response was defined as ≥50% improvement in the NRS at 1 year postinjection. On the basis of the Pfirman classification, the LBP group was divided into less-degenerative (Grades II and III) and degenerative (Grades IV and V) subgroups.</p><p><strong>Results: </strong>Seventy-nine patients were classified into the LBP group. Of these patients, 61 (77.2%) showed a >50% reduction in LBP, and another 61 (77.2%) demonstrated a >50% reduction in lower extremity pain. Improvement of lower limb pain was considerably better in the less-degenerative group than in the degenerative group, whereas that of low back pain was similar between the two subgroups. Medical costs, which include remuneration for injection, drug fees, inpatient costs, and other expenses, were similar between the LBP group and all cases.</p><p><strong>Conclusions: </strong>This retrospective multicenter study revealed that patients with LDH with severe LBP frequently experienced improvement in radicular pain and LBP, which is similar to LDH cases without severe LBP.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"368-374"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Planning for Cervical Pedicle Screw Placement: Identifying Key Morphological Parameters.","authors":"Yuya Okada, Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Jun Ouchida, Tetsuya Urasaki, Shiro Imagama","doi":"10.22603/ssrr.2024-0243","DOIUrl":"10.22603/ssrr.2024-0243","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical pedicle screw (CPS) placement is crucial for posterior cervical fusion surgery due to its strong fixation ability. However, CPS insertion is associated with risks, including screw perforation, which can lead to complications such as vertebral artery injury and neurological deficits. Although previous studies have explored some morphological factors affecting CPS placement, comprehensive data on specific parameters contributing to perforation remains limited. This study aimed to investigate cervical vertebrae features associated with CPS perforation and established threshold values for improved preoperative planning.</p><p><strong>Methods: </strong>A retrospective analysis of 36 patients who underwent posterior cervical fusion surgery with CPS placement was conducted using preoperative computed tomography (CT)-based navigation. Cases with CPS insertion at C1 or C2 were excluded. The key morphological parameters-optimal screw trajectory angle, pedicle diameter, and distance from the entry point to the pedicle isthmus (DEP)-were measured on preoperative CT images. CPS placement accuracy was assessed postoperatively using Neo's classification. The receiver operating characteristic (ROC) curve analysis determined the cutoff values for predicting CPS perforation.</p><p><strong>Results: </strong>Among the 102 CPSs placed from C3 to C7, the overall perforation rate was 25.5%. C3 had the highest perforation rate (45.5%), whereas C7 had the lowest (3.1%). The vertebrae with CPS perforation exhibited a significantly larger optimal screw trajectory angle (45.5° vs. 38.0°, p<0.001), smaller pedicle diameter (4.2 mm vs. 5.2 mm, p<0.001), and longer DEP (13.2 mm vs. 11.9 mm, p=0.002). The ROC analysis identified the following cutoff values: 44.0° for the optimal angle, 4.35 mm for the pedicle diameter, and 12.7 mm for the DEP. These morphological parameters strongly predicted the risk of CPS perforation.</p><p><strong>Conclusions: </strong>Establishing key morphological thresholds enhances preoperative planning for CPS placement, improves accuracy and patient safety, and minimizes complications.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"313-320"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electromagnetic Navigation in Biportal Endoscopic Lumbar Spine Surgery.","authors":"Dhivakaran Gengatharan, Walter Soon Yaw Wong, Lee Kai Lin, John Wen Cong Thng, Huang Yilun","doi":"10.22603/ssrr.2024-0257","DOIUrl":"https://doi.org/10.22603/ssrr.2024-0257","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic Spine Surgery (ESS) has begun to gain traction as an alternative to traditional microscopic spine surgery, particularly for lumbar decompression. However, one of the challenges associated with this approach is the steep learning curve. A recent advancement in this field aims to flatten the learning curve by incorporating navigation into ESS. This technology provides valuable information on the extent of decompression, confirms the working level, and reduces radiation exposure.</p><p><strong>Technical note: </strong>We aimed to describe our experience using electromagnetic navigation in biportal endoscopic spine surgery (BESS). The surgical technique is initiated by positioning the patient prone on a radiolucent table. The navigation field generator is positioned over the caudal end of the patient. The navigation system is set up with patient mappers at the desired working levels. The patient tracker is implanted. The final fluoroscopy images are captured in anteroposterior and lateral views. Subsequently, standard incisions are made, and endoscopic decompression is performed. When required, various instruments can be used to confirm the level, angulation, and extent of decompression.</p><p><strong>Conclusions: </strong>Our experience showed that this approach reduced the need for intraoperative imaging and provided an accurate alternative to repeated intraoperative imaging. However, it does involve a significantly long setup. Further trials of larger scale are required to determine its efficacy.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 2","pages":"258-262"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}