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Minimally Invasive Approach for Degenerative Spondylolisthesis: Lateral Single-Position Surgery with Intraoperative CT Navigation and Fluoroscopy – A Technical Note – Lumbar Spinal Stenosis

This article presents a novel surgical strategy for treating degenerative spondylolisthesis (DS) using lateral single-position surgery (SPS) in combination with intraoperative computed tomography (CT) navigation and fluoroscopy. The study involved 15 patients diagnosed with DS who underwent lateral lumbar interbody fusion (LLIF) with percutaneous pedicle screw (PPS) fixation using this technique. The results showed significant improvements in various parameters, including spondylolisthesis reduction, segmental lordosis, disc height, and spinal canal dimensions. The lateral-SPS procedure exhibited advantages over traditional flip LLIF approaches for slip reduction and provided accurate intraoperative navigation guidance. The authors conclude that this precise and efficient approach minimizes repositioning needs and holds promise as an innovative solution for managing DS. Further investigation is warranted to validate these findings

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: 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.

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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.

CONCLUSIONS: 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

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Minimally Invasive Approach for Degenerative Spondylolisthesis: Lateral Single-Position Surgery with Intraoperative CT Navigation and Fluoroscopy – A Technical Note

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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

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