The analysis of percutaneous pedicle screw technique with guide wire-less in lateral decubitus position following extrem
- PDF / 969,495 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 42 Downloads / 132 Views
(2019) 14:304
RESEARCH ARTICLE
Open Access
The analysis of percutaneous pedicle screw technique with guide wire-less in lateral decubitus position following extreme lateral interbody fusion Akihiko Hiyama*, Daisuke Sakai, Masato Sato and Masahiko Watanabe
Abstract Background: Lateral lumbar interbody fusion (LLIF) and bilateral percutaneous pedicle fixation are valuable, minimally invasive lateral approaches used to treat symptomatic degenerative disc disease. In the current procedure, the patient’s position on the operating table is changed after LLIF surgery from the lateral decubitus to the prone position. The ability to perform both approaches with the patient in the same position should reduce operation time. Use of a guide wire is problematic during percutaneous pedicle screw (PPS) insertion using fluoroscopy with the patient in the lateral decubitus position. A new guide wire-less PPS system may solve this problem and reduce operation time. Here, we evaluated the operative data and efficacy for this technique. Methods: This study included 30 patients (aged 70.8 ± 8.5 years; 17 men, 13 women) who underwent a combined operation (indirect decompression) using extreme lateral interbody fusion (XLIF) with only a single level for lumbar spinal canal stenosis and lumbar degenerative spondylolisthesis. Patient demographics and operative data were compared between two groups: patients who remained in the lateral decubitus position for pedicle screw fixation (L group) and those turned to the prone position (P group). Radiographic assessment was performed using pre- and postoperative anteroposterior and lateral lumbar films with measurement of lumbar lordosis, segmental lordosis, and segmental translation. Results: We analyzed 18 patients in the P group and 12 in the L group. Age, sex, height, body weight, body mass index, estimated blood loss, and length of stay did not differ between groups. The operation time was 34 min shorter for the L group (P group 111.9 ± 25.0 vs. L group 77.5 ± 22.2 min, p < 0.01). Pre- and postoperative lordosis, segmental lordosis, and segmental translation did not differ significantly between groups. Conclusions: A single position after XLIF surgery is a feasible modification to the standard procedure when used with fluoroscopy and a guide wire-less PPS system. The time saved is the main advantage of inserting the PPS with the patient in the lateral decubitus position without repositioning. Use of the lateral PPS with a guide wire-less technique may help improve operative efficiency and reduce cost.
Background Of the minimally invasive lateral lumbar interbody fusion (LLIF), extreme lateral interbody fusion (XLIF) and oblique lumbar interbody fusion (OLIF) are techniques used for indirect decompression of the neural structures through interbody distraction and fusion in the lumbar
* Correspondence: [email protected] Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
spine. Good results have be
Data Loading...
