Can Fan-Beam Interactive Computed Tomography Precisely Predict Oblique Decompression in Minimally Invasive Backbone Surgical procedure Fusion Procedures?
World Neurosurg. 2017 Nov;107:322-333
Authors: Janssen I, Lang G, Navarro-Ramirez R, Jada A, Berlin C, Hilis A, Zubkov M, Gandevia L, Härtl R
BACKGROUND: Lately, novel cellular intraoperative fan-beam computed tomography (CT) was launched, permitting for real-time navigation and quick intraoperative analysis of neural decompression in backbone surgical procedure. This examine sought to analyze whether or not intraoperatively assessed neural decompression throughout minimally invasive backbone surgical procedure (MISS) has a predictive worth for medical and radiographic consequence.
METHODS: A retrospective examine of sufferers present process intraoperative CT (iCT)-guided excessive lateral interbody fusion or transforaminal lumbar interbody fusion was performed. 1) Preoperative, 2) intraoperative (after cage implantation, three) postoperative, and four) follow-up radiographic and medical parameters obtained from radiography or CT have been quantified.
RESULTS: Thirty-four sufferers (41 spinal segments) have been analyzed. iCT-based navigation was efficiently achieved in all sufferers. Radiographic parameters confirmed vital enchancment from preoperatively to intraoperatively after cage implantation in each MISS procedures (excessive lateral interbody fusion/transforaminal lumbar interbody fusion) (P ? zero.05). Radiologic parameters for each MISS fusion procedures didn’t present vital variations to the assessed radiographic measures at follow-up (P > zero.05). Radiologic consequence values didn’t lower compared intraoperatively (after cage implantation) to newest follow-up.
CONCLUSIONS: Intraoperative fan-beam CT is able to assessing neural decompression intraoperatively with excessive accuracy, permitting for exact prediction of radiologic consequence and earliest potential suggestions throughout MISS fusion procedures. These findings are extremely useful for routine apply and future investigations towards discovering a threshold for neural decompression that interprets into medical enchancment. If adequate neural decompression has been confirmed with iCT imaging research, extra postoperative and/or follow-up imaging research may not be required if sufferers stay asymptomatic.
PMID: 28797980 [PubMed – indexed for MEDLINE]