O-arm Navigation Combined With Microscope-assisted MIS-TLIF in the Treatment of Lumbar Degenerative Disease.

Abstract

This is a retrospective study. The purpose of this study is to compare the clinical outcomes between O-arm navigation combined with microscope-assisted minimally invasive transforaminal lumbar interbody fusion (novel MIS-TLIF) and open-TLIF for the treatment of 1-level lumbar degenerative disease. MIS-TLIF is becoming increasingly popular; however, the limited visualization may increase various surgical complications. O-arm navigation and microscope have the potential to display the specific anatomic structures and better magnification. This study involved 45 patients with 1-level lumbar degenerative disease who underwent novel MIS-TLIF or open-TLIF. Operating time, intraoperative blood loss, and hospitalization stay were analyzed. The accuracy of pedicle screw placement was assessed by computed tomography. Visual analog scale (VAS) scoring and Oswestry disability index (ODI) were assessed preoperatively and postoperatively. Intraoperative blood loss was significantly less in the novel MIS-TLIF group compared with the open-TLIF group (P<0.05). The average time for hospitalization stay in the novel MIS-TLIF group was significantly shorter than open-TLIF group (P<0.05). However, the operative time of novel MIS-TLIF group was longer than open-TLIF group (P<0.05). The accuracy rate of pedicle screw position in the novel MIS-TLIF group which guided by O-arm navigation was higher than conventional open-TLIF group (96.4% vs. 86.5%; P<0.05). Meanwhile, the VAS score for the low back pain and ODI score in the novel MIS-TLIF group were lower than that in the open-TLIF group 1 month after surgery (P<0.05). No difference of the VAS score for leg pain was found between these 2 groups (P>0.05), neither as the fusion rate in between the 2 groups (P>0.05). O-arm navigation combined with microscope-assisted MIS-TLIF may has several advantages including less blood loss, shorter hospitalization stay, higher accuracy of pedicle screw placement, and faster recovery period in treating 1-level lumbar degenerative disease.