Fluoroscopy time analysis of a prospective, multi‐centre study comparing robotic‐ and fluoroscopic‐guided placement of percutaneous pedicle screw instrumentation for short segment minimally invasive lumbar fusion surgery

2020 ◽  
Author(s):  
Aria M. Jamshidi ◽  
Dustin H. Massel ◽  
Jason I. Liounakos ◽  
Zmira Silman ◽  
Christopher R. Good ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Lumbar Fusion ◽  
Time Analysis ◽  
Short Segment ◽  
Multi Centre Study ◽  
Fusion Surgery ◽  
Centre Study ◽  
Lumbar Fusion Surgery ◽  
Percutaneous Pedicle Screw

scholarly journals Comparisons of Lumbar Muscle Performance Between Minimally-Invasive and Open Lumbar Fusion Surgery at 1-Year Follow-Up

2020 ◽  
pp. 219256822097966
Author(s):  
Meng-Ling Lu ◽  
Chih-Hsiu Cheng ◽  
Wen-Chien Chen ◽  
Chen-Ju Fu ◽  
Chi-Chien Niu
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Muscle Function ◽  
Lumbar Fusion ◽  
Muscle Performance ◽  
Functional Score ◽  
Back Muscle ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery ◽  
Significant Difference

Study Design: Prospective study. Objective: Minimally-invasive lumbar fusion surgery (MIS) is a viable alternative to conventional open surgery (COS) for spinal disorders. Although MIS seems to be associated with less para-spinal muscle trauma, the actual back muscle performance after MIS and COS remain controversial. This study investigated post-operative para-spinal muscle performance, and the correlation between muscle dysfunction and clinical outcome. Methods: In this prospective, non-randomized control study, 50 patients were enrolled and split into 2 groups: COS and MIS. We established a biomechanical model of the para-spinal muscle in the lumbar spine using electromyography (EMG) and specific muscle function tests. Functional outcomes were also reviewed and analyzed. All patients underwent EMG pre-operatively, and at 3 months and 1 year post-operatively. The para-spinal muscle performance was investigated by comparing the back muscle co-contraction ratio and the load transmission zone to the pre-operative data. Results: Twenty-one patients in the COS group and 25 in the MIS group completed the study. Both groups showed a significant improved functional score. The abdominal and back muscle strengths were decreased post-operatively, and were then increased at 12 months post-operatively in both groups. During the perturbed balance task and static task, the MIS group exhibited a trend of recovery in comparison with the COS group. But, the back muscle performance at 12 months was poorer than the pre-op performance in both groups. Conclusions: There was no significant difference in clinical outcome and para-spinal muscle performance between groups. In both methods, the global muscle function had declined post-operatively.

Clinical Assessment of Percutaneous Lumbar Pedicle Screw Placement Using the O-Arm Multidimensional Surgical Imaging System

Neurosurgery ◽  
2011 ◽  
Vol 70 (4) ◽  
pp. 990-995 ◽  
Author(s):  
John K. Houten ◽  
Rani Nasser ◽  
Nrupen Baxi
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Imaging System ◽  
Intraoperative Imaging ◽  
Lumbar Fusion ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Percutaneous Pedicle Screw ◽  
Clinical Series

Abstract BACKGROUND: Increasing popularity of minimally invasive surgery for lumbar fusion has led to dependence upon intraoperative fluoroscopy for pedicle screw placement, because limited muscle dissection does not expose the bony anatomy necessary for traditional, freehand techniques nor for registration steps in image-guidance techniques. This has raised concerns about cumulative radiation exposure for both surgeon and operating room staff. The recent introduction of the O-arm Multidimensional Surgical Imaging System allows for percutaneous placement of pedicle screws, but there is limited clinical experience with the technique and data examining its accuracy. OBJECTIVE: We present the first large clinical series of percutaneous screw placement using navigation of O-arm imaging and compare the results with the fluoroscopy-guided method. METHODS: A retrospective review of a 24-month period identified patients undergoing minimally invasive lumbar interbody fusion. The O-arm was introduced in the middle of this period and was used for all subsequent patients. Accuracy of screw placement was assessed by examination of axial computed tomography or O-arm scans. RESULTS: The fluoroscopy group included 141 screws in 42 patients, and the O-arm group included 205 screws in 52 patients. The perforation rate was 12.8% in the fluoroscopy group and 3% in the O-arm group (P < .001). Single-level O-arm procedures took a mean 200 (153–241) minutes, whereas fluoroscopy took 221 (178–302) minutes (P < .03). CONCLUSION: Percutaneous pedicle screw placement with the O-arm Multidimensional Intraoperative Imaging System is a safe and effective technique and provided improved overall accuracy and reduced operative time compared with conventional fluoroscopic techniques.

scholarly journals Comparison of cortical bone trajectory versus pedicle screw techniques in lumbar fusion surgery

Medicine ◽  
2019 ◽  
Vol 98 (33) ◽  
pp. e16751 ◽  
Author(s):  
Jing-Nan Hu ◽  
Xiao-Feng Yang ◽  
Chuan-Ming Li ◽  
Xin-Xin Li ◽  
Yun-Zhi Ding
Keyword(s):  
Cortical Bone ◽  
Pedicle Screw ◽  
Lumbar Fusion ◽  
Fusion Surgery ◽  
Cortical Bone Trajectory ◽  
Lumbar Fusion Surgery

scholarly journals Women Do Not Have Poorer Outcomes After Minimally Invasive Lumbar Fusion Surgery: A Five-Year Follow-Up Study

10.14444/7108 ◽  
2020 ◽  
Vol 14 (5) ◽  
pp. 756-761
Author(s):  
WINSTON SHANG RONG LIM ◽  
MING HAN LINCOLN LIOW ◽  
GRAHAM SEOW-HNG GOH ◽  
WILLIAM YEO ◽  
ZHIXING MARCUS LING ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Lumbar Fusion ◽  
Fusion Surgery ◽  
Follow Up Study ◽  
Lumbar Fusion Surgery

scholarly journals Minimally Invasive Transforaminal Lumbar Interbody Fusion Ameliorates Persistent Pain After Lumbar Fusion Surgery

2020 ◽  
Author(s):  
Jun Li ◽  
Kai Liu ◽  
Li Yang ◽  
DEGUO WANG
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Persistent Pain ◽  
Lumbar Interbody Fusion ◽  
Fusion Surgery ◽  
Drainage Fluid ◽  
Lumbar Fusion Surgery ◽  
Degenerative Lumbar Diseases

Abstract Background: Approximately 4-20% patients with degenerative lumbar diseases showed persistent pain after lumbar fusion surgery that may develop into failed back surgery syndrome (FBSS), and this persistent pain may be related to the postoperative increased release of inflammatory mediators. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) can obviously reduce the intraoperative soft tissue trauma. The aim of this study is to investigate the persistent pain in the patients with degenerative lumbar diseases undergoing MIS-TLIF compared with conventional‑invasive TLIF. Material and methods: This study retrospectively included 146 patients (MIS-TLIF vs. conventional‑invasive TLIF: 56 vs. 90), and the incidence of persistent pain were evaluated. Furthermore, inflammation related markers in both blood and drainage fluid samples, including white blood cell (WBC) count, C-reactive protein (CRP), creatine kinase (CK), interleukin-6 (IL-6) and IL-1β, were tested before and after operation. Results: Significantly larger number of patients undergoing conventional‑invasive TLIF showed postoperative persistent pain compared to those undergoing MIS-TLIF (4/56, 7.1% vs. 20/90, 22.2%; P < 0.05). In both treatment groups, the patients with postoperative persistent pain showed increased IL-6 and IL-1β in drainage fluid, as well as increased IL-6 in blood samples (P < 0.05), and there is significant correlation between the inflammation markers in drainage fluid and the extent of postoperative persistent pain in patients with postoperative persistent pain (P < 0.05). Conclusions: Local inflammatory substance accumulation may be potential cause for postoperative persistent pain, and MIS-TLIF may reduce this inflammatory accumulation at the surgical site and subsequently reduce the risk of persistent pain.

Radiation Exposure in Minimally Invasive Lumbar Fusion Surgery

Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jan-Helge Klingler ◽  
Christoph Scholz ◽  
Marie T. Krüger ◽  
Yashar Naseri ◽  
Florian Volz ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Lumbar Fusion ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery
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