Comparison of Perioperative Factors during Minimally Invasive Prepsoas Lateral Interbody Fusion of the Lumbar Spine using either Navigation or Conventional Fluoroscopy

Presented at SMISS Annual Forum 2016
By Ian White
With Dean Chou MD, Yuehui Zhang PhD, MD, Eric Potts MD, Jean-Pierre Mobasser ,

Disclosures: Ian White None Dean Chou MD None, Yuehui Zhang PhD, MD None, Eric Potts MD F; Medtronic., Jean-Pierre Mobasser F; Medtronic.,

Introduction

oblique lateral interbody fusion (OLIF) has been applied in the treatment of degenerative diseases of the lumbar spine. In this operation, fluoroscopic guidance is most often used; however, navigation has been shown to improve accuracy of implant placement and reduce radiation exposure, but there may be prolonged operaive time, increased costs, and more set up time. 

Aims/Objectives

To compare intraoperative conditions and clinical results of patients undergoing pre-psoas OLIFusing navigation or conventional fluoroscopy (C-ARM) techniques. 

Methods

Patients underwent the OLIF procedure at two tertiary care medical centers, and records were reviewed. Forty two patients were identified; 22 patients underwent the OLIF with navigation, and 20 underwent the procedure with fluoroscopy. Operating time, estimated blood loss, length of hospitalization, surgery-related complications, total radiation exposure and total radiation time were recorded and compared between the 2 groups. Clinical outcomes according to the Smiley-Webster Scale were evaluated. Patients were followed up with a range of 6 to 24 months.

Results

There were no significant differences between groups in the mean age, gender, weight, primary diagnosis and surgical procedures. The navigation group had zero radiation exposure and radiation time compared to the C-ARM group, with total radiation exposure of 44.59±26.65 mSv and radiation time of 88.30±58.28 seconds (P<0.05). Operative time was slightly longer in the navigation group (2.49±1.35 h) compared to the C-ARM group (2.30±1.17 h) (P>0.05), although not statistically significant. No differences were found in estimated blood loss, length of hospitalization, surgery-related complications and outcome score with average 8 month fellow up.

Conclusions

Compared with C-ARM techniques, the using navigation can eliminate radiation exposure to surgeon, and it had no significant effect on operating time, estimated blood loss, length of hospitalization, or peri-operative complications in the patients with OLIF procedure. This study shows that navigation is a safe and reliable tool for surgeons in the OLIF procedure in the treatment of lumbar degenerative diseases.