Effect of an Adjustable Hinged Carbon Fiber Operating Table on the Coronal Alignment of the Lumbar Spine During Oblique Lateral Interbody Fusion.

OBJECTIVE

We sought to measure the coronal alignment of the lumbar spine of patients in the right lateral decubitus position on a hinged Jackson operating table with the following 3 table positions: neutral and right and left 20-degree flexion.

METHODS

We analyzed the data of 23 patients who underwent OLIF. Spinal alignment was quantified using the coronal Cobb angle from L1 to S1, measured on anterior-posterior radiographs obtained preoperatively, after induction of anesthesia, with patients in the right lateral decubitus position, for the following 3 positions of the Jackson hinged operating table: neutral, right 20-degree flexion, and left 20-degree flexion. The Cobb angle at each position, the change in the Cobb angle, and the effective range of motion (%) were obtained from neutral to right and left 20-degree flexion. Alignment was compared between the 3 positions, and the range of motion was compared between men and women.

RESULTS

The Cobb angle was different in all 3 positions of the table (P < 0.0001): -7.0 ± 8.7°, neutral; 2.8 ± 7.6°, right 20-degree flexion; and -14.7 ± 7.8°, left 20-degree flexion. The change in Cobb angle and the effective range of motion were greater in women (10.9 ± 2.8° and 55%) than in men (6.7 ± 5.8° and 34%) from the neutral to right 20-degree flexion position (P = 0.0298).

CONCLUSIONS

The coronal alignment of the lumbar spine of patients in the right lateral decubitus position on a flat operating table (neutral position) was convex. The right 20-degree flexion position of the hinged operating table yielded less coronal plane lumbar spine deformity, with greater deformity in women.