Preoperative Localization Methods for Minimally Invasive Surgery in Lumbar Spine

Abstract

This is a prospective single-center nonrandomized control clinical study involving 220 patients who underwent the novel localization method or conventional methods preoperatively in a minimally invasive surgery in lumbar spine. To introduce a novel preoperative locator designed by the authors for a minimally invasive surgery in lumbar spine and to compare the novel localization method with conventional methods in mean localization time and the mean number of C-arm fluoroscopy use preoperatively. Conventional localization methods for minimally invasive surgery in lumbar spine are associated with more fluoroscopy time and radiation exposure. We describe a novel preoperative locator to help localize spinal anatomic landmarks, minimize preoperative localization time, and decrease radiation exposure. There have been no prospective clinical reports published on the comparison of the novel localization method with conventional methods. A total of 220 patients, 86 (39.1%) men and 134 (60.9%) women with an average age of 53.8±16.4 years were prospectively evaluated. We divided all patients into 2 groups. Group A: the first 100 patients who received the conventional preoperative localization methods (the palpation method and the Kirschner wire method). Group B: the remaining 120 patients who localized the spinal levels with the help of the novel locator before surgery. The localization time and the number of C-arm fluoroscopy use preoperatively were recorded. The mean localization time of patients in groups A and B were 7.37±3.77 and 3.85±2.45 minutes, respectively. The mean number of preoperative C-arm fluoroscopy use in groups A and B were 2.29 and 1.29. There was significant difference in mean localization time and the mean number of C-arm fluoroscopy use between groups A and B (P<0.05). There was no incidence of wrong-level surgery in both groups. The novel preoperative locator is a simple and practical device that can help to minimize preoperative localization time and decrease radiation exposure.