Integration of advanced imaging and surgical navigation in the treatment of unstable thoracolumbar spine fractures: a systematic review of functional, neurological and postoperative outcomes

Abstract

Advanced imaging and surgical field have improved treatment and management of unstable thoracolumbar spine fractures significantly. Its emergence is boosting surgical accuracy, efficiency and its use has increased patient recovery rate. This systematic analysis is conducted to explore how these technologies affect functional, neurological and postoperative outcomes. Our aim is to evaluate and investigate previous evidences and various studies. This systematic analysis will be based entirely on retrospective analyses, randomized controlled trials, and other systematic reviews. While conducting methodology, we assessed several factors like pedicle screw placement accuracy, surgery time, radiation exposure and noted overall patient outcomes across different navigation systems like intraoperative CT navigation (iCT-Nav), 3D navigation, and augmented reality. The primary results of this systematic review revealed pedicle screw placement accuracy was high (up to 96.9% with iCT-Nav), with fewer revision surgeries needed. 3D navigation reduced fluoroscopy time significantly (p=0.0002) while still maintaining accuracy and evidence confirmed these techniques also helped lower blood loss (p<0.05) and improved spinal alignment without adding significant time to the surgery. Evidence showed radiation exposure remained an issue with varying levels of dose-length product (DLP) but it was dependent on the complexity of the procedures. Conservative management failed in 9.2% of cases while long-segment stabilization helped prevent further vertebral fractures. After all these results, we came to a conclusion that advanced imaging and navigation technologies have revolutionized thoracolumbar fracture management because its use has improved accuracy and patient outcomes which is confirmed. These technologies are also seen to reduce the need for revision surgeries and made minimally invasive surgeries more effective and also helped stabilize the spine in the long term. The challenges linked to these procedures are radiation exposure, standardization and costs which need to be carefully handled and need attention. Future research should explore what the role of artificial intelligence is and how it can work to bring maximum outcomes while making these technologies more accessible is also critical.