title: Screw placement accuracy for minimally invasive transforaminal lumbar interbody fusion surgery: a study on 3-d neuronavigation-guided surgery.
abstract: Purpose The aim of this study was to assess the impact of 3-D navigation for pedicle screw placement accuracy in minimally invasive transverse lumbar interbody fusion (MIS-TLIF). Methods A retrospective review of 52 patients who had MIS-TLIF assisted with 3D navigation is presented. Clinical outcomes were assessed with the Oswestry Disability Index (ODI), Visual Analog Scales (VAS), and MacNab scores. Radiographic outcomes were assessed using X-rays and thin-slice computed tomography. Result The mean age was 56.5 years, and 172 screws were implanted with 16 pedicle breaches (91.0% accuracy rate). Radiographic fusion rate at a mean follow-up of 15.6 months was 87.23%. No revision surgeries were required. The mean improvement in the VAS back pain, VAS leg pain, and ODI at 11.3 months follow-up was 4.3, 4.5, and 26.8 points, respectively. At last follow-up the mean postoperative disc height gain was 4.92 mm and the mean postoperative disc angle gain was 2.79 degrees. At L5-S1 level, there was a significant correlation between a greater disc space height gain and a lower VAS leg score. Conclusion Our data support that application of 3-D navigation in MIS-TLIF is associated with a high level of accuracy in the pedicle screw placement.
authors.affiliation: Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York ; These authors contributed equally.
authors.forename: Jorge
authors.initials: J
authors.lastname: Torres
authors.affiliation: Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York ; These authors contributed equally.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: James
authors.affiliation: Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York.
authors.forename: Marjan
authors.initials: M
authors.lastname: Alimi
authors.affiliation: Clinical Radiology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York.
authors.forename: Apostolos John
authors.initials: AJ
authors.lastname: Tsiouris
authors.affiliation: Clinical Radiology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York.
authors.forename: Christian
authors.initials: C
authors.lastname: Geannette
authors.affiliation: Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York.
authors.forename: Roger
authors.initials: R
authors.lastname: Härtl
keywords: 3D-NAV; minimally invasive spine surgery; neuronavigation; pedicle screw; transforaminal lumbar interbody fusion