Fluoroscopy vs. cone-beam CT with navigation in spine: 4 key findings


A new study published in Spine compares fluoroscopy and cone-beam CT with navigation for lumbar disc space preparation.

The study authors asked two orthopedic surgeons to perform disc space preparations for eight cadavers that were assigned fluoroscopy or CBCT with navigation. The surgeons prepared 40 disc spaces overall, with 20 being lumbar disc levels in fluoroscopy; three thoracolumbar and 17 lumbar disc spaces were prepared with CBCT and navigation.

Study authors found:

1. The CBCT with navigation group reported a higher percentage of the total disc removal in relation to the total disc area, when researchers compared both techniques using digital imaging software.

2. The researchers examined the anterior contralateral and posterior contralateral quadrants and found CBCT with navigation was also associated with more disc removal than fluoroscopy.

3. The study did not find difference in the time it took to complete the disc space preparation or the number of instrument passes for either group. The number of endplate violations was also similar between the two groups.

4. Study authors concluded, "CBCT+N guidance may be used to assess instrument placement for interbody disc space preparation in a similar length of time, with no difference in instrument passes or endplate violations, in comparison with fluoroscopy."

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