Bauer David E, Lauper Nicolas, Dominguez Dennis E
Spine Team, Division of Orthopedic Surgery and Musculoskeletal Trauma Care, Geneva University Hospitals, Faculty of Medecine, University of Geneva, Geneva, Switzerland.
Spine Team, Division of Orthopedic Surgery and Musculoskeletal Trauma Care, Geneva University Hospitals, Faculty of Medecine, University of Geneva, Geneva, Switzerland
Int J Spine Surg. 2025 Mar 6;19(1):70-80. doi: 10.14444/8697.
Navigation increases the precision and safety of pedicle screw placement and has been used to place interbody cages for lateral lumbar interbody fusion. Single-position surgery shortens its duration and that of anesthesia. The aim of this study was the feasibility of simultaneous cage and screw placement in a single prone position using intraoperative navigation without the need for additional fluoroscopy and a detailed technical description of this procedure.
We retrospectively analyzed 15 patients who underwent simultaneous navigated lateral lumbar interbody fusion and posterior instrumentation in a single prone position. A detailed technical description of the procedure is provided. Surgery duration, blood loss, complications, and radiographic parameters were recorded.
A total of 24 cages were placed in 15 patients. The mean time taken for cage placement was 21 ± 6.70 minutes, and there were no major complications. Mean surgery duration and blood loss per case, including posterior instrumentation, were 263 ± 94 minutes and 315 ± 143 mL, respectively. There were significant improvements in pre- to postoperative Oswestry Disability Index scores (51.38 ± 15.93 vs 32.81 ± 17.18, < 0.001) and segmental lordosis (3.26° ± 8.97° vs 13.09° ± 15.25°, < 0.001).
The present study's results showed the feasibility of lateral lumbar interbody fusion using simultaneous posterior pedicle screw instrumentation and intraoperative navigation in a single prone position.
Navigated lateral lumbar interbody fusion and posterior instrumentation in a single prone position possibly reduces operating time and blood loss and reduces exposure of operation room personnel to radiation.
导航技术提高了椎弓根螺钉置入的精度和安全性，并已用于腰椎侧方椎间融合术中椎间融合器的置入。单体位手术缩短了手术时间和麻醉时间。本研究的目的是探讨在术中导航下于单一俯卧位同时置入椎间融合器和螺钉的可行性，且无需额外的透视检查，并对该手术进行详细的技术描述。
我们回顾性分析了15例在单一俯卧位接受同时导航下腰椎侧方椎间融合术和后路内固定术的患者。提供了该手术的详细技术描述。记录手术时间、失血量、并发症和影像学参数。
15例患者共置入24个椎间融合器。椎间融合器置入的平均时间为21±6.70分钟，未发生重大并发症。包括后路内固定术在内，每例手术的平均时间和失血量分别为263±94分钟和315±143毫升。术前至术后Oswestry功能障碍指数评分（51.38±15.93对32.81±17.18，<0.001）和节段性前凸（3.26°±8.97°对13.09°±15.25°，<0.001）有显著改善。
本研究结果表明，在单一俯卧位同时进行后路椎弓根螺钉内固定和术中导航下腰椎侧方椎间融合术是可行的。
在单一俯卧位进行导航下腰椎侧方椎间融合术和后路内固定术可能会减少手术时间和失血量，并减少手术室人员的辐射暴露。
