Effect of an Adjustable Hinged Carbon Fiber Operating Table on the Coronal Alignment of the Lumbar Spine During Oblique Lateral Interbody Fusion

World Neurosurg. 2021 May:149:e958-e962. doi: 10.1016/j.wneu.2021.01.066. Epub 2021 Feb 12.

Abstract

Objective: We sought to measure the coronal alignment of the lumbar spine of patients in the right lateral decubitus position on a hinged Jackson operating table with the following 3 table positions: neutral and right and left 20-degree flexion.

Methods: We analyzed the data of 23 patients who underwent OLIF. Spinal alignment was quantified using the coronal Cobb angle from L1 to S1, measured on anterior-posterior radiographs obtained preoperatively, after induction of anesthesia, with patients in the right lateral decubitus position, for the following 3 positions of the Jackson hinged operating table: neutral, right 20-degree flexion, and left 20-degree flexion. The Cobb angle at each position, the change in the Cobb angle, and the effective range of motion (%) were obtained from neutral to right and left 20-degree flexion. Alignment was compared between the 3 positions, and the range of motion was compared between men and women.

Results: The Cobb angle was different in all 3 positions of the table (P < 0.0001): -7.0 ± 8.7°, neutral; 2.8 ± 7.6°, right 20-degree flexion; and -14.7 ± 7.8°, left 20-degree flexion. The change in Cobb angle and the effective range of motion were greater in women (10.9 ± 2.8° and 55%) than in men (6.7 ± 5.8° and 34%) from the neutral to right 20-degree flexion position (P = 0.0298).

Conclusions: The coronal alignment of the lumbar spine of patients in the right lateral decubitus position on a flat operating table (neutral position) was convex. The right 20-degree flexion position of the hinged operating table yielded less coronal plane lumbar spine deformity, with greater deformity in women.

Keywords: Adjustable hinged operating table; Cobb angle; Coronal lumbar alignment; Oblique lateral interbody fusion.

MeSH terms

  • Aged
  • Carbon Fiber
  • Diskectomy
  • Equipment Design*
  • Female
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery*
  • Male
  • Operating Tables*
  • Patient Positioning / instrumentation
  • Patient Positioning / methods*
  • Range of Motion, Articular
  • Sex Factors
  • Spinal Fusion / methods*

Substances

  • Carbon Fiber