ArticleFrontiers in surgery2026
An innovative 2D optical navigation workflow for percutaneous pedicle screw fixation in thoracolumbar fractures: comparison with O-arm 3D navigation.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Thoracolumbar fractures (TLFs) are common spinal injuries caused by high-energy trauma, falls, or osteoporosis. Traditional open surgery may involve substantial blood loss, tissue damage, and prolonged recovery. Percutaneous pedicle screw fixation (PPSF) is minimally invasive and can accelerate rehabilitation, but it often depends on repeated fluoroscopy, increasing radiation exposure and potential neurovascular risk. This study compared the clinical outcomes of two-dimensional (2D) optical navigation and three-dimensional (3D) navigation systems for PPSF in TLFs, focusing on operative time, radiation dose, screw placement accuracy, clinical recovery, complications, and learning curves. Methods: We retrospectively analyzed 105 patients with TLFs who underwent PPSF at our center from January 2020 to February 2024. Patients were divided into a 2D-navigation group (PPSF assisted by a 2D optical navigation system) and a 3D-navigation group (PPSF guided by a 3D navigation system). Intraoperative and postoperative outcomes-including operative time, radiation dose, pedicle screw accuracy, and clinical recovery assessed by visual analog scale (VAS) and Oswestry Disability Index (ODI)-were compared between groups. The learning curve for each system was evaluated using cumulative sum (CUSUM) analysis. Results: The 2D-navigation group had significantly shorter operative times (94.71 ± 14.38 vs. 105.40 ± 11.22 min) and lower radiation doses (81.0 ± 16.9 vs. 137.2 ± 43.0 µGy·m Conclusion: Compared with 3D navigation, 2D optical navigation reduced operative time and radiation exposure while maintaining comparable screw placement accuracy and clinical outcomes. With simpler operation and a shorter learning curve, 2D navigation-assisted PPSF may improve procedural efficiency and represents a promising alternative for minimally invasive treatment of thoracolumbar fractures.
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