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Review
. 2022 Aug 29:2022:8419739.
doi: 10.1155/2022/8419739. eCollection 2022.

Navigation Techniques in Endoscopic Spine Surgery

Matthew J Hagan  1 , Thibault Remacle  2 , Owen P Leary  1   3 , Joshua Feler  1   3 , Elias Shaaya  1   3 , Rohaid Ali  1   3 , Bryan Zheng  1 , Ankush Bajaj  1 , Erik Traupe  4 , Michael Kraus  5 , Yue Zhou  6 , Jared S Fridley  1   3 , Kai-Uwe Lewandrowski  7 , Albert E Telfeian  1
Affiliations
Review

Navigation Techniques in Endoscopic Spine Surgery

Matthew J Hagan et al. Biomed Res Int. .

Abstract

Endoscopic spine surgery (ESS) advances the principles of minimally invasive surgery, including minor collateral tissue damage, reduced blood loss, and faster recovery times. ESS allows for direct access to the spine through small incisions and direct visualization of spinal pathology via an endoscope. While this technique has many applications, there is a steep learning curve when adopting ESS into a surgeon's practice. Two types of navigation, optical and electromagnetic, may allow for widespread utilization of ESS by engendering improved orientation to surgical anatomy and reduced complication rates. The present review discusses these two available navigation technologies and their application in endoscopic procedures by providing case examples. Furthermore, we report on the future directions of navigation within the discipline of ESS.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
Images from optical navigation use in endoscopic spine surgery. (a) The white arrow shows the entry site to the disc space of the target level. (b) Screenshot of the navigated endoscope at Kambin's triangle. (c) Screenshot from the view of the endoscope showing the L4-5 disc space with the PEEK implant in place. (d) The white arrow points at the completed foraminotomy at the target level.
Figure 2
Figure 2
Patient installed in prone position. The two mappers and the electromagnetic field generator are fixed to the table by articulated arms. Anteroposterior and lateral mappers are placed to cover the desire working area, while the electromagnetic field generator is oriented with a 45° angle toward the working area.
Figure 3
Figure 3
Two K-wires are fixed in a spinous process close to the working area (a). Patient tracker fixed to the K-wires and the extensions are cut to avoid electromagnetic disturbance (b and c).
Figure 4
Figure 4
Final position of patient tracker, patient mappers, and electromagnetic field generator before fluoroscopy.
Figure 5
Figure 5
Two fluoroscopy shots are taken: one anteroposterior (a, c) and one lateral (b, d). The mappers should cover the desire navigable area.
Figure 6
Figure 6
Photography of the Intracs monitor depicting the planification of the entry point after having registered the needle.
See this image and copyright information in PMC

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