Navigated Lateral Osteotomy for Adult Spinal Deformity: A Technical Note

World Neurosurg. 2021 Jun:150:56-63. doi: 10.1016/j.wneu.2021.03.088. Epub 2021 Mar 24.

Abstract

Background: Minimally invasive surgery is receiving considerable attention as a technique for reducing the complications of adult spinal deformity (ASD) surgery. For this technique, a new lateral osteotomy plays an important role to release fused vertebrae. We describe herein a novel navigated lateral osteotomy technique not requiring C-arm fluoroscopy to correct adult spinal deformities.

Case description: A 68-year-old woman with symptomatic ASD and a 4-year history of severe low back pain affecting daily life was referred to our hospital. Surgery was performed without C-arm fluoroscopy. A navigated osteotome was used to release the fused L1/2 mass. The patient was successfully treated with surgery, and low back pain was well controlled. In terms of clinical outcomes, Oswestry Disability Index improved from 64%-19% and Visual Analog Scale score for low back pain improved from 74 mm-19 mm on final follow-up at 2 years.

Conclusions: This novel navigated lateral osteotomy for ASD is a useful technique that enables minimally invasive surgery for fixed deformity. With this new technique, surgeons and operating room staff can avoid adverse effects of intraoperative radiation.

Keywords: Adult spinal deformity; C-arm-free; Intraoperative radiation; Lateral osteotomy; Navigated osteotome; Navigation.

MeSH terms

  • Aged
  • Female
  • Humans
  • Lordosis / diagnostic imaging*
  • Lordosis / surgery*
  • Minimally Invasive Surgical Procedures
  • Neuronavigation / methods*
  • Neurosurgical Procedures / methods*
  • Osteotomy / methods*
  • Treatment Outcome