gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Minimally invasive instrumentation and reduction of high-grade lumbar spondylolisthesis with O-Arm navigation

Meeting Abstract

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  • M.G. Detzner - Neurochirurgische Klinik Köln-Merheim, Universitätsklinikum Witten-Herdecke, Standort Köln-Merheim
  • F.W. Weber - Neurochirurgische Klinik Köln-Merheim, Universitätsklinikum Witten-Herdecke, Standort Köln-Merheim

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.08.08

DOI: 10.3205/12dgnc359, URN: urn:nbn:de:0183-12dgnc3591

Published: June 4, 2012

© 2012 Detzner et al.
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Outline

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Objective: Presentation of the clinical experience with correction and fusion in lumbar spondylolisthesis by percutaenous navigated TLIF procedures using the O-arm.

Methods: Analysis of prospectively collected cohort of patients (SSE Spine Tango), who suffer from degenerative mono- or bisegmental spondylolisthesis up to and including Meyerding grade II-III. The primary outcome of this minimally invasive “percutaneous” TLIF surgery was examined radiologically and regarding quality of life.

Results: In the period from August 2009 to April 2011, 73 motion segments in 65 patients at a mean age of 62.8 years (29–80 years) were operated mono-or bisegmental (12.31%) using a percutaneous reduction system (Sextant Reduction II, Medtronic FA) and TLIF cages. A good (<2 mm) to complete reduction of the alignments was achieved in all patients with homogeneous correction of lumbar lordosis. In 10.77% of the operations a cementing of the screws in advance of the reduction was performed. Three postoperative screw dislocations in senile osteoporosis and one during early physical strain of a power athlete also led to a reintervention – for osteoporosis with screw augmentation. The blood loss was on average less than 500 ml per segment. The operating time was on average 241 min. All patients underwent CT in the follow-up. There was no relevant screw malpositioning. In two patients there was eccentric positioning within the pedicle. Dural injury (1.54%) was sutured intraoperatively. An intraoperative perforation of a cage led to a temporary leg weakness (1.54%). Excepting two subcutaneous hematomas (3.08 %) in the access area, there were no other postoperative complications. There was a significant reduction in pain levels for low back pain and radicular symptoms by 2.1 respective 2.9. The mean total duration of inpatient stay was 6.8 days.

Conclusions: The minimally invasive percutaneous instrumentation via posterolateral approaches to the lumbar motion segments, repositioning and TLIF is a safe surgical technique. The reduction of listhesis for correction of sagital profile is certainly feasible with respect to the specific biomechanical aspects of the system used and the quality of the vertebral body bone. The rate of fusion using autogenous bone and osteoconductors is currently being investigated prospectively.