Transforming spinal surgery: five years of navigation, workflow optimization and clinical impact
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By
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April 20, 2026
Objective:
To analyze the utilization of navigated dorsal spinal instrumentation over a 5-year period at a Level I trauma center and compare procedural characteristics, efficiency metrics, and radiation parameters with fluoroscopic techniques, specifically focusing on changes after the introduction of navigation in 2020.
Key Findings:
- Navigation use increased and expanded to more complex anatomical regions, particularly after its introduction in 2020.
- Navigated cases involved older patients with higher ASA scores.
- Operative times were longer for navigated procedures due to higher screw counts, but time per screw improved significantly after the learning curve.
- Radiation time was significantly lower in the navigated group.
- Screw misplacement-related revisions were less frequent with navigation (1% vs. 5%).
Interpretation:
Navigation significantly improved screw accuracy and reduced radiation exposure while maintaining procedural efficiency, particularly after the learning curve.
Limitations:
- Single-center study may limit generalizability.
- Retrospective design may introduce bias, as it relies on existing records and may not capture all variables.
Conclusion:
Navigation has transformed clinical practice in spinal surgery, particularly for complex anatomies and higher-risk patients, with potential for further advancements through robotics and augmented reality.
