EXPRESS: Accuracy of intraoperative computed tomography to determine implant position in the feline vertebral spine.

Intraoperative C-arm CBCT is accurate and fast for assessing feline spinal implant position.

This in vitro study evaluated three imaging modalities for assessing implant position relative to the vertebral canal during feline thoracolumbar spinal surgery. Twenty-two cadaveric specimens underwent realistic surgical approaches with placement of 1.2mm Kirschner wires at three thoracolumbar locations, including intentional canal perforations. End-on fluoroscopy (eoF), multi-slice computed tomography (MSCT), and cone-beam computed tomography (CBCT) via C-arm were compared against anatomic dissection as the gold standard. CBCT demonstrated superior sensitivity (88.5%) and specificity (83.4%) with balanced accuracy of 85.9%, compared to eoF (81.3%) and MSCT (81.7%). Interrater reliability was good for all modalities but best for CBCT (kappa 0.58). CBCT and eoF acquisition times were significantly faster than MSCT. The study demonstrates that intraoperative C-arm CBCT provides accurate, rapid assessment of implant positioning relative to the feline spinal canal, making it a valuable intraoperative tool for vertebral implant surgery.

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