Intraoperative computed tomography-guided navigation versus fluoroscopy for single-position surgery after lateral lumbar interbody fusion

2021 ◽  
Vol 93 ◽  
pp. 75-81
Author(s):  
Akihiko Hiyama ◽  
Hiroyuki Katoh ◽  
Satoshi Nomura ◽  
Daisuke Sakai ◽  
Masahiko Watanabe
Keyword(s):  
Computed Tomography ◽  
Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Intraoperative Computed Tomography ◽  
Lateral Lumbar Interbody Fusion

Analysis of Intraoperative Cone-Beam Computed Tomography Combined With Image Guidance for Lateral Lumbar Interbody Fusion

2017 ◽  
Vol 14 (6) ◽  
pp. 620-626
Author(s):  
Xilin Liu ◽  
Jacob R Joseph ◽  
Brandon W Smith ◽  
Yamaan Saadeh ◽  
Paul Park
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Cone Beam Computed Tomography ◽  
Interbody Fusion ◽  
Cone Beam ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Spinal Navigation ◽  
Male Patients ◽  
Biplanar Fluoroscopy

Abstract BACKGROUND Minimally invasive lateral lumbar interbody fusion (LLIF) is traditionally performed with biplanar fluoroscopy. Recent literature demonstrates that intraoperative cone-beam computed tomography combined with spinal navigation can be safely utilized for localization and cage placement in LLIF. OBJECTIVE To evaluate the accuracy and safety of cage placement using spinal navigation in LLIF, as well as to evaluate the radiation exposure to surgeon and staff during the procedure. METHODS The authors performed a retrospective analysis of a prospectively acquired database of patients undergoing LLIF with image-based navigation performed from April 2014 to July 2016 at a single institution. The medical records were reviewed, and data on clinical outcomes, cage accuracy, complications, and radiation exposure were recorded. All patients underwent a minimum 30-d clinical follow-up to assess intraoperative and short-term complications associated with their LLIF. RESULTS Sixty-three patients comprising 117 spinal levels were included in the study. There were 36 (57.1%) female and 27 (42.9%) male patients. Mean age was 62.7 yr (range 24-79 yr). A mean 1.9 (range 1-4) levels per patient were treated. Cages were placed in the anterior or middle of 115 (98.3%) disc spaces. Image-guided cage trajectory was accurate in 116/117 levels (99.1%). In a subgroup analysis of 18 patients, mean fluoroscopy time was 11.7 ± 9.7 s per level. Sixteen (25.4%) patients experienced a complication related to approach. CONCLUSION Use of intraoperative cone-beam computed tomography combined with spinal navigation for LLIF results in accurate and safe cage placement as well as significantly decreased surgeon and staff radiation exposure.

Lateral lumbar interbody fusion in revision surgery for restenosis after posterior decompression

2020 ◽  
Vol 49 (3) ◽  
pp. E11 ◽  
Author(s):  
Yoshifumi Kudo ◽  
Ichiro Okano ◽  
Tomoaki Toyone ◽  
Akira Matsuoka ◽  
Hiroshi Maruyama ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Decompression Surgery ◽  
Complication Rates ◽  
Lumbar Interbody Fusion ◽  
Posterior Decompression ◽  
Lateral Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Dural Tears

OBJECTIVEThe purpose of this study was to compare the clinical results of revision interbody fusion surgery between lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) with propensity score (PS) adjustments and to investigate the efficacy of indirect decompression with LLIF in previously decompressed segments on the basis of radiological assessment.METHODSA retrospective study of patients who underwent revision surgery for recurrence of neurological symptoms after posterior decompression surgery was performed. Postoperative complications and operative factors were evaluated and compared between LLIF and PLIF/TLIF. Moreover, postoperative improvement in cross-sectional areas (CSAs) in the spinal canal and intervertebral foramen was evaluated in LLIF cases.RESULTSA total of 56 patients (21 and 35 cases of LLIF and PLIF/TLIF, respectively) were included. In the univariate analysis, the LLIF group had significantly more endplate injuries (p = 0.03) and neurological deficits (p = 0.042), whereas the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), surgical site infections (SSIs) (p = 0.02), and estimated blood loss (EBL) (p < 0.001). After PS adjustments, the LLIF group still showed significantly more endplate injuries (p = 0.03), and the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), EBL (p < 0.001), and operating time (p = 0.04). The PLIF/TLIF group showed a trend toward a higher incidence of SSI (p = 0.10). There was no statistically significant difference regarding improvement in the Japanese Orthopaedic Association scores between the 2 surgical procedures (p = 0.77). The CSAs in the spinal canal and foramen were both significantly improved (p < 0.001).CONCLUSIONSLLIF is a safe, effective, and less invasive procedure with acceptable complication rates for revision surgery for previously decompressed segments. Therefore, LLIF can be an alternative to PLIF/TLIF for restenosis after posterior decompression surgery.

Sign in / Sign up

Export Citation Format

Share Document