Abstract
Endoscopic spine surgery (ESS) is an ultra-minimally invasive technique through which spinal pathology can be addressed via sub-centimeter incisions with negligible soft tissue disruption. However, concerns exist regarding the steep learning curve, operative time, and radiation exposure to the surgical team. The use of intraoperative navigation, mixed reality, and robotics in the setting of ESS is currently being explored, and the early evidence suggests that such technologies may help mitigate these issues. The application of these technologies in ESS as well as the associated literature is reviewed herein.
Highlights
Invasive spine surgery (MISS) aims to improve clinical outcomes while minimizing soft tissue damage, blood loss, recovery time, and pain
There were no significant differences in clinical outcomes and no complications associated with the use of navigation
There were no differences in clinical outcomes, but the use of mixed reality was associated with significant reductions in operative time (18.48 ± 6.38 min vs. 23.87 ± 9.64 min, P = 0.003) and radiation exposure to the surgeon (13.59 ± 4.56 mGy vs. 18.62 ± 7.07 mGy, P < 0.001)
Summary
Invasive spine surgery (MISS) aims to improve clinical outcomes while minimizing soft tissue damage, blood loss, recovery time, and pain. Ultrasound volume navigation (UVN) is a technique that fuses preoperative CT or magnetic resonance imaging (MRI) data to real-time ultrasound It has been used in conjunction with an electromagnetic tracker in early feasibility studies to facilitate localization and docking for transforaminal endoscopic lumbar discectomies[22,23]. There were no differences in clinical outcomes, but the use of mixed reality was associated with significant reductions in operative time (18.48 ± 6.38 min vs 23.87 ± 9.64 min, P = 0.003) and radiation exposure to the surgeon (13.59 ± 4.56 mGy vs 18.62 ± 7.07 mGy, P < 0.001). CT navigation, robotics, and mixed reality reduce surgeon radiation exposure but require a preoperative CT scan, thereby increasing radiation exposure to the patient These techniques require the placement of a reference marker which increases the surgical morbidity of ESS. As these technologies become more available, the costs will decrease and reduce the financial barriers to their adoption
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
