Jonathan E. Webb MD , Gilad J. Regev MD , Steven R. Garfin MD , Choll W. Kim MD, PhD
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This study assesses the use of navigation for the DLIF procedure in comparison to standard fluoroscopy (FLUORO), as well as the accuracy of the NAV MIS DLIF procedure.</p></div><div><h3>Methods</h3><p>Three fresh whole-body cadavers underwent multiple DLIF procedures at the T10-L5 levels via either NAV or FLUORO. Radiation exposure and surgical times were recorded and compared between groups. An additional cadaver was used to evaluate the accuracy of the NAV system for the DLIF procedure by measuring the deviation error as the surgeon worked further from the anterior superior iliac spine tracker.</p></div><div><h3>Results</h3><p>Approach, discectomy, and total fluoroscopy times for FLUORO were longer than NAV (<em>P</em> < .05). In contrast, the setup time was longer in NAV (<em>P</em> = .005). Cage insertion and total operating times were similar for both. Radiation exposure to the surgeon for NAV was significantly less than FLUORO (<em>P</em> < .05). Accuracy of the NAV system was within 1 mm for L2-5.</p></div><div><h3>Conclusion</h3><p>Navigation for the DLIF procedure is feasible. Accuracy for this procedure over the most common levels (L2-5) is likely sufficient for safe clinical application. Although initial setup times were longer with NAV, simultaneous anteroposterior and lateral imaging with the NAV system resulted in overall surgery times similar to FLUORO. Navigation minimizes fluoroscopic radiation exposure.</p></div><div><h3>Clinical significance</h3><p>Navigation for the DLIF procedure is accurate and decreases radiation exposure without increasing the overall surgical time.</p></div>","PeriodicalId":88695,"journal":{"name":"SAS journal","volume":"4 4","pages":"Pages 115-121"},"PeriodicalIF":0.0000,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.esas.2010.09.002","citationCount":"11","resultStr":"{\"title\":\"Navigation-assisted fluoroscopy in minimally invasive direct lateral interbody fusion: a cadaveric study\",\"authors\":\"Jonathan E. Webb MD , Gilad J. Regev MD , Steven R. Garfin MD , Choll W. 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引用次数: 11
摘要
背景微创手术(MIS)依赖于术中透视成像进行可视化，这大大增加了辐射暴露。导航辅助透视(NAV)可以通过减少对实时透视的需求，潜在地减少辐射暴露，改善手术室环境。直接外侧椎体间融合术(DLIF)是一种MIS椎体间腰椎和胸椎体间融合术。本研究评估了与标准透视(FLUORO)相比，导航在DLIF程序中的使用，以及NAV MIS DLIF程序的准确性。方法对3具新鲜尸体进行T10-L5水平的多次DLIF手术，分别采用NAV或FLUORO。记录两组间的辐射暴露和手术时间并进行比较。另一具尸体被用来评估NAV系统用于DLIF手术的准确性，通过测量当外科医生远离髂前上棘跟踪器时的偏差误差。结果氟组入路、椎间盘切除术和全透视时间均长于NAV组(P <. 05)。相比之下，NAV的设置时间更长(P = 0.005)。两者的笼插入时间和总手术时间相似。NAV对外科医生的辐射暴露明显小于氟化(P <. 05)。L2-5的NAV系统精度在1mm以内。结论DLIF手术导航是可行的。该方法在最常见的水平(L2-5)上的准确性可能足以安全的临床应用。虽然NAV的初始设置时间较长，但NAV系统同时进行正位和侧位成像的总体手术时间与FLUORO相似。导航最大限度地减少透视辐射暴露。临床意义:DLIF手术的导航准确，在不增加总手术时间的情况下减少了辐射暴露。
Navigation-assisted fluoroscopy in minimally invasive direct lateral interbody fusion: a cadaveric study
Background
Minimally invasive surgery (MIS) is dependent on intraoperative fluoroscopic imaging for visualization, which significantly increases exposure to radiation. Navigation-assisted fluoroscopy (NAV) can potentially decrease radiation exposure and improve the operating room environment by reducing the need for real-time fluoroscopy. The direct lateral interbody fusion (DLIF) procedure is a technique for MIS intervertebral lumbar and thoracic interbody fusions. This study assesses the use of navigation for the DLIF procedure in comparison to standard fluoroscopy (FLUORO), as well as the accuracy of the NAV MIS DLIF procedure.
Methods
Three fresh whole-body cadavers underwent multiple DLIF procedures at the T10-L5 levels via either NAV or FLUORO. Radiation exposure and surgical times were recorded and compared between groups. An additional cadaver was used to evaluate the accuracy of the NAV system for the DLIF procedure by measuring the deviation error as the surgeon worked further from the anterior superior iliac spine tracker.
Results
Approach, discectomy, and total fluoroscopy times for FLUORO were longer than NAV (P < .05). In contrast, the setup time was longer in NAV (P = .005). Cage insertion and total operating times were similar for both. Radiation exposure to the surgeon for NAV was significantly less than FLUORO (P < .05). Accuracy of the NAV system was within 1 mm for L2-5.
Conclusion
Navigation for the DLIF procedure is feasible. Accuracy for this procedure over the most common levels (L2-5) is likely sufficient for safe clinical application. Although initial setup times were longer with NAV, simultaneous anteroposterior and lateral imaging with the NAV system resulted in overall surgery times similar to FLUORO. Navigation minimizes fluoroscopic radiation exposure.
Clinical significance
Navigation for the DLIF procedure is accurate and decreases radiation exposure without increasing the overall surgical time.
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