ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
The safety and accuracy of radiation-free spinal navigation using a short, scoliosis-specific BoneMRI-protocol, compared to CT.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Long-term cancer risk in historic cohorts of patients with adolescent idiopathic scoliosis: a systematic review.Spine deformity · 2026Pooled it
- Utilization of Magnetic Resonance Imaging-based Synthetic Computed Tomography for Pedicle Screw Navigation in Children: A Feasibility Study.Journal of the Pediatric Orthopaedic Society of North America · 2026Article
- Artificial Intelligence in Intraoperative Imaging and Navigation for Spine Surgery: A Narrative Review.Journal of clinical medicine · 2026Review
- Review
- Evaluation of magnetic resonance imaging and deep learning-based synthetic computed tomography for calcified intradural tumors - importance of domain-specific training and validation of synthetic imaging methods for clinical application.Acta neurochirurgica · 2025Observational
- Quantification of Thoracic Volume and Spinal Length of Pediatric Scoliosis Patients on Chest MRI Using a 3D U-Net Segmentation.Healthcare (Basel, Switzerland) · 2025Article
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10 authors.
Funding
Abstract
purposeSpinal navigation systems require pre- and/or intra-operative 3-D imaging, which expose young patients to harmful radiation. We assessed a scoliosis-specific MRI-protocol that provides T2-weighted MRI and AI-generated synthetic-CT (sCT) scans, through deep learning algorithms. This study aims to compare MRI-based synthetic-CT spinal navigation to CT for safety and accuracy of pedicle screw planning and placement at thoracic and lumbar levels.
methodsSpines of 5 cadavers were scanned with thin-slice CT and the scoliosis-specific MRI-protocol (to create sCT). Preoperatively, on both CT and sCT screw trajectories were planned. Subsequently, four spine surgeons performed surface-matched, navigated placement of 2.5 mm k-wires in all pedicles from T3 to L5. Randomization for CT/sCT, surgeon and side was performed (1:1 ratio). On postoperative CT-scans, virtual screws were simulated over k-wires. Maximum angulation, distance between planned and postoperative screw positions and medial breach rate (Gertzbein-Robbins classification) were assessed.
results140 k-wires were inserted, 3 were excluded. There were no pedicle breaches > 2 mm. Of sCT-guided screws, 59 were grade A and 10 grade B. For the CT-guided screws, 47 were grade A and 21 grade B (p = 0.022). Average distance (± SD) between intraoperative and postoperative screw positions was 2.3 ± 1.5 mm in sCT-guided screws, and 2.4 ± 1.8 mm for CT (p = 0.78), average maximum angulation (± SD) was 3.8 ± 2.5° for sCT and 3.9 ± 2.9° for CT (p = 0.75).
conclusionMRI-based, AI-generated synthetic-CT spinal navigation allows for safe and accurate planning and placement of thoracic and lumbar pedicle screws in a cadaveric model, without significant differences in distance and angulation between planned and postoperative screw positions compared to CT.
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