PDF(Pubmed)
Abstract：
OBJECTIVE: Single-position surgery with patients in a lateral position, which involves inserting percutaneous pedicular screws (PPS) and lateral interbody fusion (LIF) to avoid changing the position, has been reported. The purpose of the present study was to evaluate the utility and appropriateness of single-position LIF-PPS using O-arm-based navigation in the innovative oblique position.
METHODS: This study involved a retrospective analysis of 92 consecutive patients with lumbar spondylolisthesis who underwent LIF-PPS using O-arm-based navigation. Thirty-five subjects demonstrated surgery with repositioning, as well as 24 in the lateral decubitus position, and 33 in the oblique during PPS, where the position was changed to the lateral decubitus position using bed rotation without resetting. We compared these three groups in terms of the surgery time, blood loss, and the accuracy of the screw placement.
RESULTS: The operative time was significantly shorter in the single-position surgery, both in the lateral and oblique positions, compared to surgery in a dual position. The blood loss was significantly increased in the lateral position compared to the dual and oblique positions. The screw trajectory angle on the downside was significantly smaller in the lateral position, and the accuracy of the screw placement on the downside was significantly lower in the lateral position compared to the dual and oblique positions.
CONCLUSIONS: Single-position surgery could reduce the average surgery time by about 60 min. The present study indicated the oblique position during PPS insertion might make single-position surgery more useful to improve the accuracy of PPS on the downside, with less blood loss.
METHODS: This study involved a retrospective analysis of 92 consecutive patients with lumbar spondylolisthesis who underwent LIF-PPS using O-arm-based navigation. Thirty-five subjects demonstrated surgery with repositioning, as well as 24 in the lateral decubitus position, and 33 in the oblique during PPS, where the position was changed to the lateral decubitus position using bed rotation without resetting. We compared these three groups in terms of the surgery time, blood loss, and the accuracy of the screw placement.
RESULTS: The operative time was significantly shorter in the single-position surgery, both in the lateral and oblique positions, compared to surgery in a dual position. The blood loss was significantly increased in the lateral position compared to the dual and oblique positions. The screw trajectory angle on the downside was significantly smaller in the lateral position, and the accuracy of the screw placement on the downside was significantly lower in the lateral position compared to the dual and oblique positions.
CONCLUSIONS: Single-position surgery could reduce the average surgery time by about 60 min. The present study indicated the oblique position during PPS insertion might make single-position surgery more useful to improve the accuracy of PPS on the downside, with less blood loss.
摘要：
目的：侧卧位患者的单位置手术，其中包括插入经皮椎弓根螺钉（PPS）和外侧椎间融合术（LIF）以避免改变位置，已被报道。本研究的目的是在创新的倾斜位置使用基于O-arm的导航来评估单位置LIF-PPS的实用性和适当性。
方法：本研究对92例连续腰椎滑脱患者进行了回顾性分析，这些患者使用基于O-arm的导航进行了LIF-PPS。35名受试者展示了重新定位的手术，以及侧卧位置的24，在PPS期间倾斜33，在没有复位的情况下，使用床旋转将位置更改为侧卧位。我们比较了三组的手术时间,失血,和螺钉放置的准确性。
结果：单位手术的手术时间明显缩短，在横向和倾斜位置，与双重位置的手术相比。与双位和斜位相比，侧位的失血量显着增加。侧面位置的螺杆轨迹角度明显较小,与双位置和倾斜位置相比，侧面位置的螺钉放置精度明显较低。
结论：单体位手术平均可减少手术时间约60分钟。本研究表明，在PPS插入过程中的倾斜位置可能使单位置手术更有用，以提高PPS的准确性。减少失血。
方法：本研究对92例连续腰椎滑脱患者进行了回顾性分析，这些患者使用基于O-arm的导航进行了LIF-PPS。35名受试者展示了重新定位的手术，以及侧卧位置的24，在PPS期间倾斜33，在没有复位的情况下，使用床旋转将位置更改为侧卧位。我们比较了三组的手术时间,失血,和螺钉放置的准确性。
结果：单位手术的手术时间明显缩短，在横向和倾斜位置，与双重位置的手术相比。与双位和斜位相比，侧位的失血量显着增加。侧面位置的螺杆轨迹角度明显较小,与双位置和倾斜位置相比，侧面位置的螺钉放置精度明显较低。
结论：单体位手术平均可减少手术时间约60分钟。本研究表明，在PPS插入过程中的倾斜位置可能使单位置手术更有用，以提高PPS的准确性。减少失血。
