Initial Experience with O-Arm Navigated Spinal Surgery - Report on Two Cases.

Image-guided spinal surgery is becoming increasingly popular because it allows surgeons to achieve minimal invasiveness and maximum precision in the performed procedures. We present our initial experience with two cases operated on using O-arm-based spinal navigation at the Clinic of Neurosurgery in St George University Hospital, Plovdiv, Bulgaria. In the first case, we performed removal of extradural spinal tumor of the sixth thoracic vertebra and O-arm-navigated pedicle screw fixation. In the second case, we performed O-arm-navigated corpectomy of the fifth cervical vertebra and anterior spinal reconstruction and fusion with titanium expandable mesh and cervical plate in connection with degenerative narrowing of the cervical spinal canal that lead to clinically manifested myelopathy. The initial experience allows us to conclude that O-arm-based image-guided spinal surgery can lead to considerably higher precision of spinal instrumented procedures. At the same time, it reduces the irradiation dose of the patient and surgical team.