BackgroundThe current study presents a technique (navigated posterior lumbar fusion) which takes a 5-cm incision to accomplish a 2-level posterior lumbar fusion (PLF) and compared its efficacy and efficiency with those of conventional PLF.MethodsForty patients who were indicated for 2-level lumbar fusion were included and randomized to either navigated PLF group or conventional PLF group. Blood loss, operation time, incision length, complications, bed rest period, and length of hospitalization were recorded. Oswestry Disability Index (ODI) scoring was also performed for each patient before surgery, 3 months after surgery, and 2 years after surgery.ResultsThe incision length was significantly shorter in the navigated PLF group than in the conventional PLF group (4.8 vs. 10.9 cm, p = 0.001). Accordingly, the blood loss was also significantly less in the navigated PLF group than in the conventional PLF group (209.0 vs. 334.0 ml, p = 0.047). There was no significant difference in total operation time between the two groups (160.7 vs. 144.4 min, p = 0.116). Compared to the conventional PLF group, the navigated PLF group showed significantly less postoperative blood loss, less time to mobilization, and shorter length of hospital stay. The ODI score improved significantly in the both groups immediately after surgery, and maintained well in the following 2 years.ConclusionCompared to conventional PLF, navigated PLF proved to be superior with regard to incision length, blood loss, time to mobilization, and shorter length of hospital stay.

The current study presents a navigated transforaminal lumbar interbody fusion (TLIF) technique that requires only a 4-cm incision to accomplish a single-level TLIF. The authors compared its efficacy and efficiency with those of conventional TLIF. Forty patients who were indicated for single-level lumbar fusion were included and randomized to either the navigated-TLIF group or the conventional-TLIF group. Intraoperative blood loss, operative time, incision length, complications, bed rest period, and length of hospital stay were recorded. Oswestry Disability Index (ODI) scoring was also performed for each patient preoperatively and 3 months and 2 years postoperatively. Incision length was significantly shorter in the navigated-TLIF group than in the conventional-TLIF group (4.2 vs 8.3 cm, respectively; P=.001). Accordingly, intraoperative blood loss was also significantly less in the navigated-TLIF group than in the conventional-TLIF group (122.5 vs 220.5 mL, respectively; P=.049). There was no significant difference in total operative time between the 2 groups (134.4 vs 124.5 minutes; P=.226). The navigated-TLIF group had a significantly shorter bed rest period and length of hospital stay compared to the conventional-TLIF group. Incision length decreased with time; at final follow-up, average incision length had decreased from 4.2 to 3.7 cm in the navigated-TLIF group and from 8.3 to 7.7 cm in the conventional-TLIF group. Average ODI score improved significantly in both groups immediately postoperatively and was maintained in the following 2 years. Navigation can make single-level TLIF less invasive. Compared with conventional TLIF, navigated TLIF proved to be superior with regard to incision length, intraoperative blood loss, bed rest period, and length of hospital stay. [Orthopedics.2016; 39(5):e857-e862.].