Department of Spinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao, China.
Orthop Surg. 2024 Oct;16(10):2552-2561. doi: 10.1111/os.14179. Epub 2024 Aug 19.
Oblique lumbar interbody fusion (OLIF) has become a popular technique for treating adult degenerative scoliosis (ADS), but traditional OLIF technology often requires repositioning for one-stage or staged posterior fixation. The objective of this pilot study was to describe the surgical technique of simultaneous single-position OLIF and percutaneous pedicle screw fixation (OLIF 360) under O-Arm navigation for modified MISDEF type II ADS.
Between June 2022 and December 2023, six patients classified as having modified MISDEF type II ADS underwent OLIF 360 assisted by O-Arm navigation at our institution. Intraoperative blood loss, duration of operation, and complications related to the OLIF 360 procedure were recorded. The preoperative and postoperative spinal pelvic parameters were measured using X-rays. The accuracy of pedicel screws was recorded in accordance with the modified Gertzbein-Robbins classification on CT. Postoperative MRI was performed to evaluate the indirect decompressive effect. The Japanese Orthopedic Association score for low back pain was used to evaluate surgical outcomes.
Navigated OLIF 360 were performed in six ADS patients with 44 percutaneous pedicel screws and 16 cages placement, including four women and two men. The mean operation time was 160.83 ± 33.23 min, and the mean blood loss was 111.67 ± 39.71 mL. Postoperative spinal pelvic parameters and spinal stenosis degree improved significantly on X-ray and MRI. All screws were clinically acceptable according to the Gertzbein-Robbins classification, with 92.7% grade A and 7.3% grade B. No serious intraoperative and postoperative adverse events were recorded in all patients. The JOA scores for low back pain of all patients were significantly improved at postoperative 1 month and the final follow-up.
We report on a case series and describe navigated OLIF 360 in treating modified MISDEF type II ADS patients. Navigation-assisted OLIF 360 has shown encouraging surgical outcomes with good spinal imbalance correction and indirect decompression.
斜侧腰椎体间融合术（OLIF）已成为治疗成人退行性脊柱侧凸（ADS）的一种流行技术，但传统的 OLIF 技术通常需要重新定位以进行一期或分期后路固定。本研究的目的是描述在 O 臂导航下改良 MISDEF Ⅱ型 ADS 行同期单体位 OLIF 和经皮椎弓根螺钉固定（OLIF 360）的手术技术。
2022 年 6 月至 2023 年 12 月，我院对 6 例改良 MISDEF Ⅱ型 ADS 患者采用 O 臂导航辅助 OLIF 360 治疗。记录术中出血量、手术时间及与 OLIF 360 相关的并发症。术前和术后均行 X 线检查测量脊柱骨盆参数。根据改良 Gertzbein-Robbins 分类，在 CT 上记录椎弓根螺钉的准确性。术后行 MRI 评估间接减压效果。采用下腰痛日本矫形协会评分（JOA）评估手术结果。
6 例 ADS 患者共行 44 枚经皮椎弓根螺钉和 16 枚椎间融合器置钉的导航 OLIF 360 手术，其中女性 4 例，男性 2 例。平均手术时间为 160.83±33.23min，平均出血量为 111.67±39.71ml。X 线片和 MRI 显示术后脊柱骨盆参数和椎管狭窄程度明显改善。所有螺钉均符合 Gertzbein-Robbins 分类的临床要求，其中 A 级 92.7%，B 级 7.3%。所有患者均未出现严重的术中及术后不良事件。所有患者术后 1 个月及末次随访时 JOA 下腰痛评分均明显改善。
我们报告了一系列病例，并描述了在改良 MISDEF Ⅱ型 ADS 患者中应用导航 OLIF 360 的情况。导航辅助 OLIF 360 治疗改良 MISDEF Ⅱ型 ADS 具有良好的脊柱失平衡矫正和间接减压效果，手术结果令人鼓舞。
