C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Oblique lumbar interbody fusion (OLIF) is effective for lumbar canal stenosis.
• OLIF at the L5-S1 level (OLIF51) presents significant technical challenges due to anatomical complexities.
• Minimizing radiation exposure and surgical time are critical in spinal fusion procedures.

Purpose of the Study:

• To present a novel, simultaneous technique for OLIF at L5-S1 (OLIF51) combined with percutaneous pedicle screw fixation.
• To perform the procedure without fluoroscopy, utilizing intraoperative navigation.
• To evaluate the feasibility and benefits of this combined, navigation-guided approach.

Main Methods:

• A lateral decubitus position was used with intraoperative navigation (O-arm and spinal navigation system).
• A retroperitoneal approach facilitated access to the L5-S1 disc space for navigated OLIF.
• Percutaneous pedicle screws were inserted simultaneously by a second surgeon, avoiding patient repositioning.

Main Results:

• The novel technique successfully combined C-arm-free OLIF51 with simultaneous percutaneous pedicle screw fixation.
• The procedure was performed entirely under navigation guidance in a lateral position.
• This approach demonstrated potential for reduced surgical duration and decreased radiation exposure.

Conclusions:

• C-arm-free OLIF51 and simultaneous percutaneous pedicle screw fixation are feasible using navigation guidance.
• This combined technique offers a promising solution to overcome the technical difficulties of OLIF51.
• The method may lead to improved patient outcomes by reducing surgical time and radiation hazards.