Robot‐Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion in the Treatment of Lumbar Spondylolisthesis

Cui, Guanyu; Han, Xiaoguang; Yi, Wei; Liu, Yajun; He, Da; Sun, Yin; Liu, Bo; Tian, Wei

doi:10.1111/os.13044

Cited by 44 publications

(53 citation statements)

References 24 publications

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“…Robot-assisted pedicle screw placement has become popular in recent years, and it has been proven to have greater screw accuracy [ 2 , 3 , 4 , 5 ], fewer proximal facet joint violations [ 2 , 6 ], and reduced radiation exposure [ 2 , 5 , 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, robotic systems have been developed to assist pedicle screw placement in spinal surgery. According to previous literature, robot-assisted pedicle screw placement has greater screw accuracy [ 2 , 3 , 4 , 5 ], fewer proximal facet joint violations [ 2 , 6 ], reduced radiation exposure [ 2 , 5 , 7 , 8 ], and shorter length of hospital stay [ 7 ]. However, only a few studies have compared the postoperative clinical and radiographic outcomes between robot-assisted pedicle screw placement and fluoroscopy-guided technique.…”

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Pedicle Screw Placement Led to Lower Screw Loosening Rate than Fluoroscopy-Guided Technique in Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Single-Center Retrospective Study

Lai

Lin

et al. 2022

JCM

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Robot-assisted pedicle screw placement for spine surgery has become popular in recent years. This study compares clinical, radiographic outcomes and the screw loosening rate between robot-assisted and fluoroscopy-guided pedicle screw placement in patients who underwent transforaminal lumbar interbody fusion (TLIF). We retrospectively examined 108 patients with the degenerative lumbar disease who underwent TLIF. According to whether the robotic system was used, patients were assigned to either the robot-assisted (Ro TLIF, n = 29) or fluoroscopy-guided TLIF (FG TLIF, n = 79) group. Radiographic parameters and patient-reported outcomes, including leg and back pain visual analog scale (VAS) and Oswestry Disability Index (ODI), were assessed. Loosening signs were noted in 48 out of 552 pedicle screws. The screw loosening rate was higher in the FG TLIF (10.2%) than Ro TLIF group (4.3%). A significant correlation was found between screw loosening and age, the number of level(s) fused, and the ratio of the average distance from the pedicle screw to the upper endplate to vertebral body height. VAS-leg, VAS-back, and ODI showed significant improvements in both groups postoperatively (all p < 0.05). These results indicated that robot-assisted pedicle screw placement in TLIF had a lower screw loosening rate and similar patient-reported outcomes compared with the fluoroscopy-guided technique.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Pedicle Screw Placement Led to Lower Screw Loosening Rate than Fluoroscopy-Guided Technique in Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Single-Center Retrospective Study

Lai

Lin

et al. 2022

JCM

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“…The fusion cage is placed in the vertebral space. but the disadvantage of PLIF is that the nerve root and dural sac need to be pulled through the midline during the operation, which increases the risk of nerve root and dural sac injury, especially above the lumbar 3 segment (23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the lack of mobility of the dural sac and the limited traction space easily lead to nerve injury (23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Application and thinking of minimally invasive transforaminal lumbar interbody fusion in degenerative lumbar diseases

Wang

et al. 2022

Ann Transl Med

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Background: This study sought to investigate the clinical efficacy and safety of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar degenerative diseases. Methods: The clinical data of 55 patients with lumbar degenerative diseases treated at our hospital from January 2018 to January 2020 were analyzed retrospectively. Of the 55 patients, 35 who underwent MIS-TLIF were included in the MIS-TLIF group, and 20 who underwent posterior lumbar interbody fusion (PLIF) were included in the PLIF group. The visual analogue scale (VAS) score, Oswestry disability index (ODI) score, operation time, incision length, intraoperative bleeding, postoperative drainage, postoperative landing time, postoperative hospital stay, postoperative interbody fusion rate, and complications were compared between the two groups.Results: The patients in both groups were followed-up for at least 1.5 years (range, 18-30 months; with an average of 27.5±2.6 months). There was no significant difference in the operation time, incision length, intraoperative bleeding, VAS score for low back and leg pain, ODI score, interbody fusion rate, hospitalization expenses, and complication rate between the two groups (P>0.05). One patient had nail failure in the MIS-TLIF group, 1 patient in each group had nerve root irritation, and 1 patient in each group had superficial incision infection and local suture dehiscence. The postoperative drainage volume, postoperative landing time, and postoperative hospital stay of the MIS-TLIF group were less than those of the PLIF group (P<0.05).Conclusions: Compared to PLIF, the use of MIS-TLIF in the treatment of lumbar degenerative diseases has a number of advantages, including more complete intraoperative hemostasis, less postoperative drainage, earlier landing, and faster discharge, and also significantly improves postoperative lumbar discomfort.

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“…The experience of Cui et al [ 91 ] with robotic-assisted pedicle screw placement in 23 MIS-TLIF patients revealed significant favorability in pedicle screw accuracy, intraoperative blood loss, postoperative pain, postoperative drainage, recovery time, and paraspinal muscle atrophy relative to 25 open TLIF patients. Lin et al [ 92 ] compared 75 MIS-TLIF patients who underwent robotic-assisted pedicle screw fixation to 149 patients receiving freehand fluoroscopy-assisted fixation, noting similar postoperative outcomes between cohorts, with robotic-assisted patients experiencing significantly reduced blood loss, as well as reduced operative time for procedures on more than 3 vertebral levels.…”

Section: Looking Ahead: Continued Evolution Of the Mis-tlifmentioning

confidence: 99%

History and Evolution of the Minimally Invasive Transforaminal Lumbar Interbody Fusion

et al. 2022

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The minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a popular surgical technique for lumbar arthrodesis, widely considered to hold great efficacy while conferring an impressive safety profile through the minimization of soft tissue damage. This elegant approach to lumbar stabilization is the byproduct of several innovations throughout the past century. In 1934, Mixter and Barr’s paper in the New England Journal of Medicine elucidated the role of disc herniation in spinal instability and radiculopathy, prompting surgeons to explore new approaches and instruments to access the disc space. In 1944, Briggs and Milligan published their novel technique, the posterior lumbar interbody fusion (PLIF), involving continuous removal of vertebral bone chips and replacement of the disc with a round bone peg. The following decades witnessed several PLIF modifications, including the addition of long pedicle screws. In 1982, Harms and Rolinger sought to redefine the posterior corridor by approaching the disc space through the intervertebral foramen, establishing the transforaminal lumbar interbody fusion (TLIF). In the 1990s, lumbar spine surgery experienced a paradigm shift, with surgeons placing increased emphasis on tissuesparing minimally invasive techniques. Spurred by this revolution, Foley and Lefkowitz published the novel MIS-TLIF technique in 2002. The MIS-TLIF has demonstrated comparable surgical outcomes to the TLIF, with an improved safety profile. Here, we present a view into the history of the posterior-approach treatment of the discogenic radiculopathy, culminating in the MIS-TLIF. Additionally, we evaluate the hallmark characteristics, technical variability, and reported outcomes of the modern MIS-TLIF and take a brief look at technologies that may define the future MIS-TLIF.

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Robot‐Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion in the Treatment of Lumbar Spondylolisthesis

Cited by 44 publications

References 24 publications

Robot-Assisted Pedicle Screw Placement Led to Lower Screw Loosening Rate than Fluoroscopy-Guided Technique in Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Single-Center Retrospective Study

Robot-Assisted Pedicle Screw Placement Led to Lower Screw Loosening Rate than Fluoroscopy-Guided Technique in Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Single-Center Retrospective Study

Application and thinking of minimally invasive transforaminal lumbar interbody fusion in degenerative lumbar diseases

History and Evolution of the Minimally Invasive Transforaminal Lumbar Interbody Fusion

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