The Impact of Intraoperative Imaging on Outcomes in Combined Neurosurgical and Reconstructive Procedures: A Systematic Review.

This systematic review evaluates the impact of intraoperative imaging on surgical outcomes in combined neurosurgical and reconstructive procedures. A comprehensive literature search was conducted across four databases, including PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), focusing on clinical trials published between 2019 and 2024. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, six studies that met stringent eligibility criteria were selected, including randomized controlled trials (RCTs) and prospective cohort studies involving imaging modalities such as intraoperative MRI (iMRI), intraoperative ultrasound (iUS), fluoroscopy, neuronavigation, and machine vision-based systems. Data were extracted on sample size, intervention type, control group characteristics, and primary surgical outcomes, including extent of resection, complication rates, and functional recovery. Qualitative synthesis revealed consistent benefits associated with intraoperative imaging, including enhanced anatomical precision, reduced complication rates, improved extent of resection, and fewer reoperations. Quality appraisal indicated low to moderate risk of bias across most studies. These findings endorse the broader integration of intraoperative imaging into complex surgical workflows and highlight the need for further research in reconstructive domains.