The Rising Use of Navigation in Pediatric Spine Procedures: Trends and Factors

BACKGROUND: Spinal navigation has been widely adopted in adult spine surgery. The purpose of this study was to characterize the use of navigation in pediatric spinal deformity surgery. METHODS: This was a retrospective cohort study. The NSQIP Pediatric database years 2016 to 2022 were used. We included patients 17 years or younger of age that received posterior spinal fusion for deformity. Our primary outcome of interest was the proportion of cases using navigation over time. Our secondary outcomes included the proportion of cases using navigation based on age (under 9 y, 10 to 17 y), etiology (idiopathic scoliosis, neuromuscular scoliosis, syndromic scoliosis, congenital scoliosis, and kyphosis), sex, surgical specialty, number of surgical levels, previous spinal surgery, and pelvic instrumentation. Rates of allogeneic transfusion, postoperative neurological injury, deep surgical site infection, and operative time were compared between the 2 groups over time. Descriptive statistics and χ 2 tests were used for analysis. Adoption curves over time were created for the entire cohort and for each etiology. RESULTS: There were 37,594 patients in this study. Navigation was used in 3219 (8.6%) cases. The proportion of cases with navigation use has increased from 2016 to 2022 (2016: 2.0% vs. 2022: 15.6%, P