5 notes on bilateral percutaneous fixation in MIS spine surgery


A study presented at the Society for Minimally Invasive Spine Surgery Annual Forum in 2016 examines patients who underwent lateral spinal fusion and bilateral percutaneous fixation.

The study includes 42 patients who underwent extreme lateral interbody fusion or oblique lateral interbody fusion and bilateral pedicle screw fixation at the lateral decubitus or prone position. The patients underwent surgery from November 2015 to July 2016. There were 162 screws placed in all.


The researchers found:


1. The average case time was 103.2 minutes for the lateral decubitus patients, compared to 182.7 minutes in the prone group. Some patients flipped to the prone group and the average flip time was 30 minutes.


2. The lateral decubitus group reported an 8.1 baseline pelvic incidence-lumbar lordosis mismatch, compared to 12.3 in the prone group. The average improvement was 4.6 degrees in the lateral decubitus group and 13.6 decrees in the prone group.


3. The average segment lordosis improvement was 4.86 degrees in the lateral decubitus group and 6.75 degrees among the prone group patients.


4. The lumbar lordosis average improvement was 4.86 degrees in the lateral decubitus group and 16.6 degrees in the prone group. The lumbar lordosis correction difference between the two groups wasn't statistically significant when the study authors corrected for the number of surgical levels.


5. No major complications occurred in either group.


The study authors concluded, "Placement of bilateral PSF with the patient remaining in the LD position after lateral lumbar interbody fusion is safe and efficient."


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