Day Case Lumbar Fusion Surgery
This article discusses a novel surgical strategy for treating degenerative spondylolisthesis (DS), a common condition that causes low back pain and neurological symptoms. The strategy involves using lateral single-position surgery (SPS) combined with intraoperative computed tomography (CT) navigation and fluoroscopy. The study included fifteen patients with DS who underwent lateral lumbar interbody fusion (LLIF) with percutaneous pedicle screw (PPS) fixation using this technique. The results showed significant improvements in spondylolisthesis reduction, segmental lordosis, disc height, and spinal canal dimensions. The lateral-SPS procedure offered advantages over traditional flip LLIF approaches, providing precise implant placement and slip reduction. The study concludes that this approach presents a promising solution for managing DS by reducing invasiveness and optimizing surgical efficiency
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spinal clinic in London
Published article
S: Combining LLIF and PPS fixation in a single procedure presents a precise, efficient approach for DS treatment, minimizing repositioning needs. This technique enables effective lumbar reconstruction, restoration of spinal stability, and improved patient outcomes. Although further investigation is warranted, lateral SPS surgery may hold promise as an innovative solution for managing DS by reducing surgical invasiveness and optimizing surgical efficiency.
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
World Neurosurg. 2023 Sep 6:S1878-8750(23)01247-0. doi: 10.1016/j.wneu.2023.08.131. Online ahead of print.ABSTRACTOBJECTIVE: Degenerative spondylolisthesis (DS) is a prevalent condition that leads to low back pain and neurological symptoms. This technical note presents a novel surgical strategy for treating DS using lateral single-position surgery (SPS) in combination with intraoperative computed tomography (CT) navigation and fluoroscopy.METHODS: Fifteen patients,
World Neurosurg. 2023 Sep 6:S1878-8750(23)01247-0. doi: 10.1016/j.wneu.2023.08.131. Online ahead of print.
ABSTRACT
OBJECTIVE: Degenerative spondylolisthesis (DS) is a prevalent condition that leads to low back pain and neurological symptoms. This technical note presents a novel surgical strategy for treating DS using lateral single-position surgery (SPS) in combination with intraoperative computed tomography (CT) navigation and fluoroscopy.
METHODS: Fifteen patients (5 males and 10 females, mean age 70.2 years) diagnosed with DS with a slip of 5mm or more underwent lateral lumbar interbody fusion (LLIF) with percutaneous pedicle screw (PPS) fixation using this technique. The procedure involved slip reduction using an upside PPS and rod fixation, followed by LLIF performed in the same lateral position. The term “upside PPS” refers to a PPS that is inserted on the ceiling side of the patient’s surgical field. Preoperative and postoperative radiographic assessments were conducted to evaluate the effectiveness of the lateral SPS.
RESULTS: The results demonstrated significant improvements in various parameters, including spondylolisthesis reduction, segmental lordosis, disc height, and spinal canal dimensions. The lateral-SPS procedure exhibited several advantages over traditional flip LLIF approaches for slip reduction. Additionally, the technique provided accurate intraoperative navigation guidance through CT imaging, ensuring precise implant placement and slip reduction.
S: Combining LLIF and PPS fixation in a single procedure presents a precise, efficient approach for DS treatment, minimizing repositioning needs. This technique enables effective lumbar reconstruction, restoration of spinal stability, and improved patient outcomes. Although further investigation is warranted, lateral SPS surgery may hold promise as an innovative solution for managing DS by reducing surgical invasiveness and optimizing surgical efficiency.
PMID:37683916 | DOI:10.1016/j.wneu.2023.08.131
The London Spine Unit : most specialised spinal clinic in London
Read the original publication:
Minimally Invasive Approach for Degenerative Spondylolisthesis: Lateral Single-Position Surgery with Intraoperative CT Navigation and Fluoroscopy – A Technical Note
