Application of O-arm Navigation in Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Spondylolisthesis
Objective To compare the clinical outcomes of O-arm navigation assisted minimally invasive transfo-raminal lumbar interbody fusion(MIS-TLIF)and C-arm assisted MIS-TLIF in the treatment of degenerative lumbar spon-dylolisthesis.Methods Data of 42 patients with single-segment degenerative lumbar spondylolisthesis who underwent O-arm-assisted or C-arm-assisted MIS-TLIF in author's hospital were analyzed from June 2022 to June 2023.The patients were divided into O-arm-assisted MIS-TLIF group(n=20)and C-arm-assisted MIS-TLIF group(n=22)according to the type of surgery.Patients in the O-arm-assisted MIS-TLIF group were treated with O-arm-assisted MIS-TLIF,and the patients in the C-arm-assisted MIS-TLIF group were treated with C-arm-assisted MIS-TLIF.Demographic variables,perioperative indicators,visual analogu scale(VAS)score of back and leg pain,Oswestry disability index(ODI)and clini-cal outcomes of patients with degenerative lumbar spondylolisthesis between two groups were evaluated and compared.Results The intraoperative blood loss and postoperative drainage volume in the O-arm-assisted MIS-TLIF group were significantly lower than those in the C-arm-assisted MIS-TLIF group,and the differences were statistically significant(all P＜0.05).The accuracy of screw placement of patients with degenerative lumbar spondylolisthesis in the O-arm-assisted MIS-TLIF group was significantly higher than that in the C-arm-assisted MIS-TLIF group and the differ-ences were statistically significant(P＜0.05).The VAS score of back pain and ODI score of patients with degenerative lumbar spondylolisthesis in two groups decreased by time(all P＜0.05).There was no significant difference in VAS score of back pain and ODI score of patients with degenerative lumbar spondylolisthesis between the two groups before surgery at the same timing(P＞0.05),at 1 week and 3 months after surgery,VAS score of back pain and ODI score of patients with degenerative lumbar spondylolisthesis in the O-arm-assisted MIS-TLIF group were lower than those in the C-arm-assisted MIS-TLIF group(all P＜0.05),there was no sig-nificant difference in VAS score of back pain and ODI score of patients with degenerative lumbar spondylolisthesis between the two groups at other timing(P＞0.05).The VAS scores of leg pain of patients with degenerative lumbar spondylolis-thesis in the two groups decreased by time(all P＜0.05).There was no significant difference in VAS score of leg pain of patients with degenerative lumbar spondylolisthesis between the two groups at each timing(P＞0.05).The overall excel-lent and good rates of Odom criteria in O-arm-assisted MIS-TLIF group and C-arm-assisted MIS-TLIF group were 85.00％and 90.91％respectively,and there was no significant difference between the two groups(P＞0.05).There was no fusion failure and related complications of patients with degenerative lumbar spondylolisthesis in the two groups at 12 months after surgery.Conclusion The O-arm-assisted MIS-TLIF is safe and effective in the treatment of single-segmentⅠ-Ⅱ degenerative lumbar spondylolisthesis,compared with the C-arm-assisted MIS-TLIF,it has the advantages of high accuracy of screw placement,small surgical trauma and less postoperative pain.
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