Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 19;11(9):1241.
doi: 10.3390/brainsci11091241.

Minimally Invasive L5 Corpectomy with Navigated Expandable Vertebral Cage: A Technical Note

Taro Yamauchi  1 , Ashish Jaiswal  1 , Masato Tanaka  1 , Yoshihiro Fujiwara  1 , Yoshiaki Oda  1 , Shinya Arataki  1 , Haruo Misawa  2
Affiliations

Minimally Invasive L5 Corpectomy with Navigated Expandable Vertebral Cage: A Technical Note

Taro Yamauchi et al. Brain Sci. .

Abstract

Background: Conventional L5 corpectomy requires a large incision and an extended period of intraoperative fluoroscopy. We describe herein a new L5 corpectomy technique.

Methods: A 79-year-old woman was referred to our hospital for leg pain and lower back pain due to an L5 vertebral fracture. Her daily life had been affected by severe lower back pain and sciatica for more than 2 months. We initially performed simple decompression surgery, but this proved effective for only 10 months.

Results: For revision surgery, the patient underwent minimally invasive L5 corpectomy with a navigated expandable cage without fluoroscopy. The second surgery took 215 min, and estimated blood loss was 750 mL. The revision surgery proved successful, and the patient could then walk using a cane. In terms of clinical outcomes, the Oswestry Disability Index improved from 66% to 24%, and the visual analog scale score for lower back pain improved from 84 to 31 mm at the 1-year follow-up.

Conclusions: Minimally invasive L5 corpectomy with a navigated expandable vertebral cage is effective for reducing cage misplacement and surgical invasiveness. With this new technique, surgeons and operating room staff can avoid the risk of adverse events due to intraoperative radiation exposure.

Keywords: C-arm free; L5 corpectomy; minimally invasive surgery; navigation; single lateral position.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pre- and postoperative images of the first surgery. (A) Preoperative mid-sagittal reconstruction CT; (B) Mid-sagittal MRI T2-weighted image; (C) Postoperative radiogram; (D) Postoperative mid-sagittal reconstruction CT.
Figure 2
Figure 2
Images at the 9-month follow-up. (A) Mid-sagittal reconstruction CT; (B) Mid-sagittal T2-weighted image; (C) Anteroposterior 3D vascular image; (D) Lateral 3D vascular image.
Figure 3
Figure 3
Postoperative images of second surgery. (A) Posteroanterior radiogram; (B) Lateral radiogram: neutral; (C) Mid-sagittal reconstruction CT; (D) Coronal reconstruction CT.
Figure 4
Figure 4
CT at final follow-up at one year. (A) Anteroposterior 3D CT; (B) Posteroanterior 3D CT; (C) Lateral 3D CT.
Figure 5
Figure 5
Position of the reference frame.
Figure 6
Figure 6
Navigated pointer and OLIF cage. (A,B) Skin incision with a navigated pointer; (C,D) Navigated OLIF cage.
Figure 7
Figure 7
Simultaneous PPS and navigated osteotome. (A) Surgical field; (B) Simultaneous PPS; (C) Neuromonitoring; (D) Navigated osteotome.
Figure 8
Figure 8
Navigated expandable cage, T2 StratosphereTM Expandable Corpectomy System. (A,B) Navigated trial; (C,D) Navigated expandable cage.
See this image and copyright information in PMC

References

    1. D’Aquino D., Tarawneh A.M., Hilis A., Palliyil N., Deogaonkar K., Quraishi N.A. Surgical approaches to L5 corpectomy: A systematic review. Eur. Spine J. 2020;29:3074–3079. doi: 10.1007/s00586-020-06617-y. - DOI - PubMed
    1. Vazan M., Ryang Y.M., Gerhardt J., Zibold F., Janssen I., Ringel F., Gempt J., Meyer B. L5 corpectomy-the lumbosacral segmental geometry and clinical outcome-a consecutive series of 14 patients and review of the literature. Acta Neurochir. 2017;159:1147–1152. doi: 10.1007/s00701-017-3084-5. - DOI - PubMed
    1. Quraishi N.A., Konig M., Booker S.J., Shafafy M., Boszczyk B.M., Grevitt M.P., Mehdian H., Webb J.K. Access related complications in anterior lumbar surgery performed by spinal surgeons. Eur. Spine J. 2013;22((Suppl. 1)):S16–S20. doi: 10.1007/s00586-012-2616-1. - DOI - PMC - PubMed
    1. Tanaka M., Fujiwara Y., Uotani K., Ayhan S., Yamauchi T., Sonawane S., Nakanishi K. Minimally invasive thoracolumbar corpectomy with navigated expandable vertebral cage: A technical note. Interdis. Neurosurg. 2021;24:101123.
    1. Anand N., Baron E.M., Thaiyananthan G., Khalsa K., Goldstein T.B. Minimally invasive multilevel percutaneous correction and fusion for adult lumbar degenerative scoliosis: A technique and feasibility study. J. Spinal Disord. Tech. 2008;21:459–467. doi: 10.1097/BSD.0b013e318167b06b. - DOI - PubMed

LinkOut - more resources