Effect of computer navigation-assisted minimally invasive direct lateral interbody fusion in the treatment of patients with lumbar tuberculosis: A retrospective study

Abstract

The benefits of navigation-assisted technologies are not entirely understood. Therefore, this study aimed to examine the outcomes of patients with lumbar tuberculosis who received computer navigation-assisted minimally invasive direct lateral interbody fusion (DLIF).This was a retrospective study of 33 patients with lumbar tuberculosis who underwent minimally invasive DLIF at the Department of Spine and Orthopedics of Guigang People's Hospital (Guangxi, China) between January 2015 and December 2016. The patients were pathologically diagnosed as lumbar tuberculosis and grouped into the navigation-assisted fluoroscopy (NAV; n = 18) and non-navigation-assisted fluoroscopy (non-NAV; n = 15) groups. X-ray exposure and operation times were assessed in all patients.All surgical procedures were successfully completed. No case was converted into open surgery. The NAV group had longer surgical preparation time but shorter operation time compared with the non-NAV group (both P <.01). Total operation time showed no significant difference between the 2 groups (P = .1). The time of radiation exposure in the non-NAV group was longer compared with that of the NAV group (53.2 ± 9.9 vs 13.5 ± 2.6 s; P <.01). There were no significant differences regarding intraoperative blood loss, postoperative drainage volume, length of hospital stay, bone fusion and complications between the 2 groups (all P >.05).Computer navigation-assisted minimally invasive DLIF could significantly reduce intraoperative radiation exposure, with no increase in total operation time.

Figure 1

Surgical procedure in the NAV group. (A) 90° lateral position. (B) O-arm three-dimensional scan of the lesion segment after installation of navigation tracers. (C) Surgical incision. (D) After establishing the channel for direct lateral interbody fusion. NAV = navigation.

Figure 2

Computer assisted vertebral screw implantation in the NAV group. (A) Puncture for channel installation under the guidance of computer navigation (B) Implantation of vertebral screws under the guidance of computer navigation. NAV = navigation.

Figure 3

Representative case of a 63-year-old male patient. (A–B) Preoperative X-ray suggested that L3 and L4 had vertebral bone destruction, damaged intervertebral space, and narrowed intervertebral space. (C) Preoperative MR suggested that L3 and L4 had bone marrow edema. (D) Preoperative CT suggested that L3 and L4 had vertebral bone destruction and narrowed intervertebral space. (E–F). Postoperative X-ray suggested adequate position of internal fixation.