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| ZHANG Changsheng,ZHOU Quan,LI Yuan.Application of electromagnetic navigation assisted percutaneous pedicle screw placement in unilateral biportal endoscopic single-level lumbar interbody fusion[J].Chinese Journal of Spine and Spinal Cord,2024,(4):355-361. |
| Application of electromagnetic navigation assisted percutaneous pedicle screw placement in unilateral biportal endoscopic single-level lumbar interbody fusion |
| Received:February 27, 2024 Revised:March 23, 2024 |
| English Keywords:Lumbar degenerative disease Transforaminal lumbar interbody fusion Unilateral biportal endoscopic spinal surgery Electromagnetic navigation |
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| English Abstract: |
| 【Abstract】 Objectives: To evaluate the value of electromagnetic navigation assisted percutaneous pedicle screw placement in unilateral biportal endoscopic transforaminal lumbar interbody fusion(UBE-TLIF). Methods: The clinical data of 34 patients with single-level lumbar degenerative diseases treated with UBE-TLIF assisted with electromagnetic navigation for percutaneous pedicle screw placement between August 2020 and August 2021 were retrospectively analyzed, and there were 18 males and 16 females, aged 43-73 years(58.4±9.4 years) with body mass index of 24.7±2.9kg/m2; 1 case was of L2/3, 5 cases were of L3/4, 17 cases were of L4/5 and 11 cases were of L5/S1(electromagnetic navigation group). A total of 20 patients treated with UBE-TLIF assisted with C-arm X-ray machine fluoroscopy for percutaneous pedicle screw placement during the same period were selected as the control group, which consisted of 11 males and 9 females, aged 35-73 years(58.1±10.2 years), with body mass index of 26.5±3.8kg/m2; 1 case was of L1/2, 1 case was of L2/3, 3 cases were of L3/4, 12 cases were of L4/5 and 3 cases were of L5/S1(C-arm fluoroscopy group). The operative time, fluoroscopy times, screw placement time, screw placement accuracy rate, and complications of the two groups were analyzed. Visual analogue scale(VAS) and Oswestry disability index(ODI) were evaluated before and after surgery. The modified MacNab criteria were used to evaluate the clinical effect at final follow-up. Results: All the patients successfully completed operation. The screw placement time, number of fluoroscopy times and operative time were 30.4±3.3min, 3.6±1.0, 173.8±23.9min in electromagnetic navigation group and 44.1±6.1min, 22.8±4.9, 190.2±12.5min in C-arm fluoroscopy group, which were significantly lower in the electromagnetic navigation group(P<0.05). The accuracy of pedicle screw placement was comparable between the two groups(97.1% vs 95%, P>0.05). There were no serious complications and revision surgery. With a mean follow-up of 17.6(6-27) months, the VAS back pain, VAS leg pain and ODI in both groups were significantly improved compared with those before surgery at all time points after operation(P＜0.05), and there was no significant difference between the two groups at the same time point(P＞0.05). According to MacNab criteria, there was no significant difference between the two groups in the rate of excellent and good results at final follow-up(97.1% vs 95%, P>0.05). Conclusions: UBE-TLIF assisted with electromagnetic navigation for percutaneous pedicle screw placement is feasible and safety in the treatment of single-level lumbar degenerative disease, with few intraoperative fluoroscopy times, high safety, and satisfactory early results. |
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