C-arm free simultaneous OLIF51 and percutaneous pedicle screw fixation in a single lateral position: A technical note

Abstract

Background: Indirect decompression for lumbar canal stenosis as a technique of minimally invasive surgery (MIS), is receiving considerable attention. Conventional MIS indirect decompression at L5-S1 is performed using intraoperative fluoroscopy. In this work, we describe a novel C-arm free simultaneous MIS indirect decompression technique for L5-S1 pathology. Methods: A 72-year-old woman with symptomatic L5 isthmic spondylolisthesis was referred to our hospital. The patient’s daily life had been affected by severe low back pain for 5 years and left leg pain for 2 years. The surgery was performed without C-arm fluoroscopy. The percutaneous pedicle screws and intervertebral cages were inserted only under navigation guidance in a single lateral position. Results: The patient was successfully treated with surgery. Her low back pain and left leg pain improved dramatically. Her clinical outcomes, the Oswestry disability index (ODI) improved from 48% to 14% and the low back pain visual analog scale (VAS) score improved from 78 mm to 23 mm at 1 year of final follow-up. Conclusions: C-arm-free simultaneous MIS indirect decompression for L5-S1 is a useful technique, which may reduce surgical time and blood loss. With this new technique, surgeons and operation room staff can avoid the risk of an adverse event of intraoperative radiation.

Keywords

• OLIF 51
• C-arm free
• Percutaneous pedicle screw
• Navigation
• Single lateral position