Effect of Intraoperative Image-Guided Spinal Navigation Technologies on Endoscopic Lumbar Spine Surgery: A Systematic Review and Meta-Analysis
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Study Design Meta-Analysis. Objectives Intraoperative image-guided spinal navigation provides real-time imaging during surgery and can enhance pathology localization, optimize working channel placement, and facilitate the learning process of Endoscopic lumbar spine surgery (ELSS). This meta-analysis examined whether intraoperative image-guided spinal navigation offers perioperative and clinical advantages in ELSS compared with conventional C-arm fluoroscopy. Methods We systematically searched PubMed, Europe PMC, Scopus, Cochrane Library, and ClinicalTrials.gov for studies comparing the perioperative and clinical outcome of intraoperative image-guided spinal navigation with conventional C-arm fluoroscopy in ELSS. Results were summarized using the mean difference (MD) or standardized mean difference (SMD) with accompanying 95% confidence intervals. Results A total of 19 studies involving 1390 patients were included for meta-analysis. Intraoperative image-guided spinal navigation in ELSS was significantly associated with a shorter total operation time (MD = −11.18 min, P < 0.01), fewer puncture attempts (MD = −2.94 times, P < .01), shorter cannulation time (MD = −12.59 min, P < 0.01), lower fluoroscopy use frequency (MD = −14.75 times, P < 0.01), lower radiation exposure (SMD = −4.18, P < 0.01), and shorter hospital stay (MD = −0.44 days, P = 0.03) compared with C-arm fluoroscopy. No significant differences in back Visual Analog Scale (VAS) scores, leg VAS scores, or Oswestry Disability Index scores were observed at up to 1 year of follow-up. Conclusion Intraoperative image-guided spinal navigation in ELSS significantly affects perioperative outcomes. However, clinical outcomes are not affected by the type of navigation. Further research is required to evaluate its cost-effectiveness across diverse health-care systems.
Source: Global Spine Journal
Authors: Yu-Che Wang, Hsu-I Chou, Ying-Fong Su, Rafael Garcia de Oliveira, Abhinav K. Sharma, Yang-Ching Chen, Anh Tuan Bui, Ching-Yu Lee, Jowy Tani, Cheng-Chun Chang, Takaki Yoshimizu, Wongthawat Liawrungrueang, Tsung-Jen Huang, Daisuke Sakai, Klaus John Schnake, Jason Pui Yin Cheung, Don Young Park, Meng-Huang Wu
Institutions: Taipei Medical University Hospital, Taipei Medical University, University of California, Irvine, UC Irvine Health, Wan Fang Hospital, Vietnam Military Medical University, National Taipei University of Technology, Seirei Hamamatsu General Hospital, University of Phayao, Tokai University, Malteser Waldkrankenhaus Erlangen, Paracelsus Medizinische Privatuniversität, University of Hong Kong
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,650
OpenAlex ID: W4414558950