Comparison of Operative Time with Conventional Fluoroscopy versus Spinal Neuronavigation in Instrumented Spinal Tumor Surgery.

Comparison of Operative Time with Conventional Fluoroscopy versus Spinal Neuronavigation in Instrumented Spinal Tumor Surgery.

World Neurosurg. 2017 Jun 09;:

Authors: Miller JA, Fabiano AJ

Abstract
OBJECTIVE: Spinal neuronavigation improves accuracy of pedicle screw placement but may increase operative time, and its use in oncological operations remains relatively unstudied. We compared the use of 2-dimensional (2D) fluoroscopy and 3-dimensional (3D) spinal neuronavigation relative to operative time in instrumented oncology procedures.
METHODS: Consecutive instrumented oncologic spinal operations for multiple myeloma or metastatic disease performed between 2012 and 2014 were retrospectively reviewed. Patients were placed in two groups based on the method used for pedicle screw placement: 2D-fluoroscopy versus spinal neuronavigation with 3D-imaging. These groups were compared by age, number of screws placed, number of laminectomy levels, operative time, estimated blood loss, length of hospital stay following surgery, and rate of reoperation due to screw misplacement.
RESULTS: Fourteen operations utilized 2D-fluoroscopy and 25 utilized spinal neuronavigation. In the fluoroscopy and neuronavigation groups, respectively, patient ages were 64.71±7.21 years and 63.24±6.95 years (p=0.534), number of screws were 8.07±1.98 and 7.84±1.34 (p=0.667), laminectomy levels were 2.18±1.25 and 1.60±1.02 (p=0.126), operative time was 200.79±34.99 minutes and 193.48±43.77 minutes (p=0.596), estimated blood loss was 790.00±769.61 ml and 389.80±551.43 ml (p=0.068), and length of stay after the operation was 7.64±4.63 days and 6.40±3.23 days (p=0.331). One patient in the 2D-fluoroscopy group and no patients in the spinal neuronavigation group required a reoperation for screw misplacement.
CONCLUSION: There was no significant difference in length of operative time when neuronavigation was compared with fluoroscopy for instrumented oncologic spinal surgery. There was a trend towards a decrease in estimated blood loss in the neuronavigation cases.

PMID: 28606580 [PubMed - as supplied by publisher]

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