ORIGINAL ARTICLE Utility of Computerized Isocentric Fluoroscopy for Minimally Invasive Spinal Surgical Techniques

Objective: The purpose of this study was to prospectively evaluate the clinical utility and accuracy of intraoperative three-dimensional fluoroscopy as an adjunct for the placement of a complex spinal instrumentation. Methods: The Siemens Iso-C three-dimensional fluoroscopy unit in the combination with the Stealth Treon computer volumetric navigational system was used. A total of 279 spinal instrumentation screws or transpedicular cannulations were performed in 69 patients. Accuracy, operative time, and amount of fluoroscopy utilization time were assessed for transforaminal lumbar interbody fusion (TLIF) and kyphoplasty cases. Results: Only 4 percutaneous transpedicular lumbar screws out of 265 total (1.5%) were malpositioned. Average operative time for TLIF cases was 185 minutes (range 114–311 minutes) for one-level and 292.6 minutes (range 173–390 minutes) for two-level proce