Utilization of Posterior Column Osteotomies Prior to Optical-Guided Navigation in Instrumented Lumbar Spine Surgery.

Optical topographic imaging (OTI)-guided navigation allows for accurate navigation even after posterior column osteotomies (PCOs), giving spine surgeons the option to place instrumentation after PCOs. Preoperative computed tomography (CT) imaging can be used safely and effectively for optical-guided navigation in cases where PCOs are performed. A middle-aged woman presented with symptomatic adult idiopathic scoliosis (AdIS). After unsuccessful conservative treatment, she underwent spinal deformity correction with posterior instrumented fusion using OTI-guided navigation. During surgery, PCOs were performed at the apical levels before instrumentation placement. After the osteotomies, accurate OTI registration was achieved using the remaining laminar surfaces, and pedicle screws were placed under navigation guidance. The patient made a full recovery, with resolution of her back and radicular pain.