{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:56:27Z","timestamp":1793998587663,"version":"4.8.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Meta-Analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Intraoperative image-guided spinal navigation provides real-time imaging during surgery and can enhance pathology localization, optimize working channel placement, and facilitate the learning process of Endoscopic lumbar spine surgery (ELSS). This meta-analysis examined whether intraoperative image-guided spinal navigation offers perioperative and clinical advantages in ELSS compared with conventional C-arm fluoroscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Europe PMC, Scopus, Cochrane Library, and ClinicalTrials.gov for studies comparing the perioperative and clinical outcome of intraoperative image-guided spinal navigation with conventional C-arm fluoroscopy in ELSS. Results were summarized using the mean difference (MD) or standardized mean difference (SMD) with accompanying 95% confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 19 studies involving 1390 patients were included for meta-analysis. Intraoperative image-guided spinal navigation in ELSS was significantly associated with a shorter total operation time (MD = \u221211.18 min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), fewer puncture attempts (MD = \u22122.94 times,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01), shorter cannulation time (MD = \u221212.59 min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), lower fluoroscopy use frequency (MD = \u221214.75 times,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), lower radiation exposure (SMD = \u22124.18,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), and shorter hospital stay (MD = \u22120.44 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03) compared with C-arm fluoroscopy. No significant differences in back Visual Analog Scale (VAS) scores, leg VAS scores, or Oswestry Disability Index scores were observed at up to 1 year of follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intraoperative image-guided spinal navigation in ELSS significantly affects perioperative outcomes. However, clinical outcomes are not affected by the type of navigation. Further research is required to evaluate its cost-effectiveness across diverse health-care systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251371591","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T14:07:17Z","timestamp":1758895637000},"page":"1268-1288","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Effect of Intraoperative Image-Guided Spinal Navigation Technologies on Endoscopic Lumbar Spine Surgery: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5651-7350","authenticated-orcid":false,"given":"Yu-Che","family":"Wang","sequence":"first","affiliation":[{"name":"Taipei Medical University Hospital"},{"name":"College of Medicine, Taipei Medical 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