title: Application of Intraoperative CT-Guided Navigation in Simultaneous Minimally Invasive Anterior and Posterior Surgery for Infectious Spondylitis.
abstract: This study was aimed at evaluating the safety and efficacy of using intraoperative computed tomography- (iCT-) guided navigation in simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. Nine patients with infectious spondylitis were enrolled in this study. The average operative time was 327.6 min (range, 210-490) and intraoperative blood loss was 407 cc (range, 50-1,200). The average duration of hospital stay was 48.9 days (range, 11-76). Out of a total of 54 pedicle screws employed, 53 screws (98.1%) were placed accurately. A reduced visual analog scale on back pain (from 8.2 to 2.2) and Oswestry disability index (from 67.1% to 25.6%) were found at the 2-year follow-up. All patients had achieved resolution of spinal infection with reduced average erythrocyte sedimentation rate (from 83.9 to 14.1 mm/hr) and average C-reactive protein (from 54.4 to 4.8 mg/dL). Average kyphotic angle correction was 10.5° (range, 8.4°-12.6°) postoperatively and 8.5° (range, 6.9°-10.1°) after 2 years. In conclusion, the current iCT-guided navigation approach has been demonstrated to be an alternative method during simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. It can provide a good intraoperative orientation and visualization of anatomic structures and also a high pedicle screw placement accuracy in patient's lateral decubitus position.
authors.affiliation: Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Meng-Huang
authors.identifier: 0000-0003-1606-2444
authors.initials: MH
authors.lastname: Wu
authors.affiliation: Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.
authors.forename: Navneet Kumar
authors.initials: NK
authors.lastname: Dubey
authors.affiliation: Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yen-Yao
authors.initials: YY
authors.lastname: Li
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chin-Chang
authors.initials: CC
authors.lastname: Cheng
authors.affiliation: Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chung-Sheng
authors.initials: CS
authors.lastname: Shi
authors.affiliation: Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Tsung-Jen
authors.identifier: 0000-0002-3640-3018
authors.initials: TJ
authors.lastname: Huang
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000737:chemistry; D005260:Female; D006801:Humans; D007239:Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D007432:Intraoperative Period; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016343:Monitoring, Intraoperative; D061646:Operative Time; D065289:Pedicle Screws; D011184:Postoperative Period; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods; D013166:Spondylitis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D002097:C-Reactive Protein