A pilot study to assess feasibility of a computer-assisted surgery system for navigation in the equine cervical spine.

CAS navigation in the equine cervical spine is feasible, with accuracy unaffected by operator surgical experience.

This pilot study evaluated the feasibility of the Synaptive Medical computer-assisted surgery (CAS) system for navigating procedures in the equine cervical spine. Using three equine cervical spine cadaver specimens (C1-T1), four participants with varying levels of surgical expertise used the CAS system to place nine radiodense pins into three anatomical targets: the intervertebral foramen, articular process joint, and intervertebral disc. A custom fiducial array was anchored to the dorsal spinous process of C2 to facilitate landmark registration. Accuracy was assessed by comparing pre- and post-procedural CT scans, with the primary outcome being the Euclidean distance between planned and achieved target points. The mean navigation error was 11.33 ± 11.02 mm, indicating moderate accuracy with notable variability. Surgical experience influenced procedure duration but did not significantly impact navigational accuracy, suggesting the system may be accessible to operators of varying skill levels. The C2 fiducial array placement proved effective for registration purposes. While the navigation error reported is relatively high compared to human surgical standards, the authors conclude that CAS integration into equine cervical spine procedures is feasible and holds promise for enhancing precision in minimally invasive approaches. The system may help reduce complications associated with accessing the equine cervical spine for procedures such as injections, discography, or surgical interventions. Larger studies with live subjects are warranted to further validate clinical applicability.

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