For a study, the researchers sought to determine if PSI was feasible and valuable in spinal decompression surgery compared to the traditional freehand (FH) technique for both experienced and inexperienced surgeons. Investigators conducted human cadaver research. On 4 fresh-frozen human cadavers, 32 midline decompressions were done. Furthermore, FH and 8 PSI-guided decompressions were performed by an expert spine surgeon and an orthopaedic resident (novice). They calculated each decompression method’s surgical time. On postoperative CT scans, the postoperative decompression area, cranial decompression extent in respect to the intervertebral disc, and lateral recess bony overhang were evaluated. The decompression area and osteotomy accuracy were assessed in the PSI group. Both methods took about the same amount of time, with the expert surgeon taking 07:25 minutes (PSI) against 06:53 minutes FH and the novice surgeon taking 12:36 minutes (PSI) compared with 11:54 minutes FH. The amount of postoperative cranial decompression and the bony overhang in the lateral recess did not differ between the 2 procedures or doctors. In addition, the novice surgeon’s postoperative decompression area was substantially bigger with the PSI than with the FH (477 vs 305 mm2; P=.01), while there was no significant difference between the 2 procedures for the experienced surgeon. In the decompression area, the execution of the decompression changed by 5% from the preoperative design, and the osteotomy planes had an accuracy of 1–3 mm. In a cadaver model, PSI-guided decompression was feasible and accurate, with a procedure time comparable with the usual FH approach, indicating that it should have been investigated further in vivo. In the investigation, PSI provided a more thorough decompression than the FH approach in the hands of a novice surgeon.