O-Arm-based image guidance in minimally invasive spine surgery: technical note.

Three-dimensional (3D) image guidance technology is gaining popularity in spine surgery. The O-Arm navigation platform, which relies on cone-beam CT images acquired in the operative position, represents the most recent advancement in this field. We report our technique for MIS pedicle screw insertion using the O-Arm system and present two illustrative cases. We used percutaneous technique for short construct cases and "transfascial" technique for long-construct cases. O-Arm based navigation in minimally invasive spine surgery is safe and feasible. This technology may improve surgical accuracy and clinical outcomes but long term prospective studies are needed to validate this.