J Minim Invasive Spine Surg Tech.  2025 Apr;10(1):124-130. 10.21182/jmisst.2024.01760.

Comparative Analysis of Anterior Cervical Discectomy and Fusion at a Single Level: Free-Hand Versus Navigation-Guided Approaches

• Mahamid A
• Maman D
• Sofer S
• Hodruj M
• Shpigelman A
• Berkovich Y
• Behrbalk E

• KMID: 2567506
• DOI: http://doi.org/10.21182/jmisst.2024.01760

Abstract

Objective
Integrating navigation technologies into spine surgery has improved precision and safety; however, traditional free-hand techniques are still widely used in anterior cervical discectomy and fusion (ACDF). This study utilized the National Inpatient Sample database to compare free-hand versus navigation-guided ACDF, analyzing complications, costs, mortality, and hospital stays.
Methods
Data from 2016 to 2019 identified 85,085 ACDF patients, including 560 navigation-guided operations. Propensity score matching was performed to balance the cohorts for demographics and comorbidities.
Results
Navigation-guided operations showed higher total costs (p<0.001) and differences in rates of chronic anemia and congestive heart failure. The length of hospital stay was similar between groups, but navigation-guided operations had higher mean total charges and increased rates of acute kidney injury and pulmonary embolism.
Conclusion
While navigation may improve surgical precision, it is associated with higher costs and certain risks. Further research is needed to evaluate the long-term benefits and cost-effectiveness of navigation-guided ACDF.

Keyword

Navigation technologies; Anterior cervical discectomy and fusion; Free-hand techniques