2023 Volume 14 Issue 5 Pages 753-758
Introduction: Lateral lumbar interbody fusion (LLIF) with intraoperative navigation is used in corrective surgery for adult spinal deformity (ASD). However, there are few reports on the accuracy of navigation in this procedure. Therefore, we investigated the frequency of navigation errors and their risk factors in patients undergoing LLIF with intraoperative CT navigation for ASD.
Methods: Eighty-eight cases in which LLIF was performed under intraoperative navigation between three vertebrae from L2/3 to L4/5 with a reference frame fixed to the iliac crest for female ASD were included. A still image of the navigation was taken each time an intraoperative LLIF cage was inserted, and the deviation from the intraoperative CT was evaluated. The patient backgrounds of cases with and without misalignment were compared.
Results: There were 7/264 (2.6%) vertebrae with cage misalignment between navigation and CT images, all with navigation errors of <2 mm in coronal sections. The frequency of errors did not differ remarkably among the vertebrae. The group with navigation errors had remarkably lower bone density than the group without; there were no remarkable differences in other parameters.
Conclusions: Navigation errors result from misalignment between the reference frame and the surgical manipulation site. It is important to place the frame in a position that is strong and does not interfere with the operative field. In cases of spinal deformity, it is necessary to ensure that correction does not alter the positional relationship between the reference frame and the LLIF-operated vertebrae.
