Fomekong E, et al. - Researchers here present their dedicated multifunctional hybrid operating room (HyOR) setup and evaluate the accuracy and safety of intraoperative three-dimensional fluoroscopy (io3DF) image-guided spinal navigation in transforaminal lumbar interbody fusion with percutaneous pedicle screw (PPS) placement. They realized that spine navigation based on io3DF images enabled them to avoid radiation exposure to the OR team while delivering minimal but sufficient radiation doses to the patients. This approach seems to achieve an accuracy rate of 99.6% for PPS placement in the safe zone, without significant complications.