Abstract
This study was aimed at evaluating the safety and efficacy of using intraoperative computed tomography- (iCT-) guided navigation in simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. Nine patients with infectious spondylitis were enrolled in this study. The average operative time was 327.6 min (range, 210–490) and intraoperative blood loss was 407 cc (range, 50–1,200). The average duration of hospital stay was 48.9 days (range, 11–76). Out of a total of 54 pedicle screws employed, 53 screws (98.1%) were placed accurately. A reduced visual analog scale on back pain (from 8.2 to 2.2) and Oswestry disability index (from 67.1% to 25.6%) were found at the 2-year follow-up. All patients had achieved resolution of spinal infection with reduced average erythrocyte sedimentation rate (from 83.9 to 14.1 mm/hr) and average C-reactive protein (from 54.4 to 4.8 mg/dL). Average kyphotic angle correction was 10.5° (range, 8.4°–12.6°) postoperatively and 8.5° (range, 6.9°–10.1°) after 2 years. In conclusion, the current iCT-guided navigation approach has been demonstrated to be an alternative method during simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. It can provide a good intraoperative orientation and visualization of anatomic structures and also a high pedicle screw placement accuracy in patient's lateral decubitus position.
Highlights
In recent years, many approaches for anterior spinal surgery have been developed to correct and treat injuries or lesions by providing adequate decompression and debridement, maintenance, and reinforcement of the stability [1, 2]
The drawback associated in these conventional methods has attracted attention towards minimally invasive spinal surgery (MISS) which provides minimized damage to paraspinal soft tissues and musculature thereby preserving tissue structures with highly reduced surgical complications
We aimed to evaluate the safety and efficacy by using iCTguided navigation in simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis
Summary
Many approaches for anterior spinal surgery have been developed to correct and treat injuries or lesions by providing adequate decompression and debridement, maintenance, and reinforcement of the stability [1, 2]. These anterior approaches faced the potential complications like vessel or nerve injuries due to a large incision and extensive anatomical dissection [3]. MISS may limit visualization and identification of anatomical landmarks during surgery due to smaller incisions and reduced soft tissue dissections that might lead to more severe complications. In order to improve the identification of anatomic structure and the accuracy of pedicle screws placement, the intraoperative
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