Trends and Outcomes of Computer-Assisted Navigation in Lumbar Spine Surgery: A National Database Analysis from 2010 to 2021.

Abstract

Database study. Given the high prevalence of degenerative lumbar pathologies, this study examines trends in computer-assisted navigation (CAN) utilization and complications in the top lumbar spine fusion procedures for degenerative conditions. Intraoperative CAN has advanced minimally invasive techniques and anatomic characterization. However, studies on the use of CAN in lumbar spine surgery remain limited. Patient data (2010-2021) was extracted from a national insurance database using ICD-9, ICD-10, and CPT codes. The top 5 lumbar degeneration codes were identified, and associated lumbar fusion CPT codes were used to create a cohort. Patients were stratified by procedures with and without CAN. Temporal and multivariable analyses were performed on postoperative complications at 90 days. A total of 771,874 lumbar fusion patients (2010-2021) were identified in the PearlDiver database, of whom 14,354 (1.86%) involved CAN. CAN utilization increased significantly from 0.62% (371 patients) in 2010 to 4.48% (2998 patients) in 2021, a 623.82% increase. The most rapid growth occurred from 2017-2021 (+189.73%). Multivariable analysis linked CAN to lower odds of revision surgery (aOR=0.79; 95% CI: 0.58-0.87) but higher odds of DVT (aOR=1.42; 95% CI: 1.28-1.76). Computer-assisted navigation (CAN) utilization in lumbar fusion has risen significantly, particularly in recent years. Outcome analysis suggests an association with reduced revision rates but increased DVT risk.