Early experience with a rapid navigation system-assisted unilateral biportal endoscopic interbody fusion for lumbar spondylolisthesis

TL;DR

This study shows that using a navigation system during a specific spinal surgery for lumbar spondylolisthesis improves early outcomes like reduced pain and shorter operation time.

Contribution

The study introduces a simple, effective two-dimensional navigation system for spinal endoscopic interbody fusion surgery.

Findings

Navigation-assisted surgery reduced operation time, fluoroscopy use, blood loss, and drainage volume.

Patients with navigation had better early postoperative low back pain relief.

No significant differences were found in other clinical indicators between the groups.

Abstract

This study aims to investigate the efficacy of a simple and effective two-dimensional integrated navigation-guided spinal endoscopic interbody fusion surgery for the treatment of lumbar spondylolisthesis.

A retrospective analysis was conducted on the clinical data of patients with lumbar spondylolisthesis treated with or without navigation. Postoperative clinical data were collected, and pain levels were assessed using the Visual Analog Scale (VAS), while functional improvement was evaluated using the Oswestry Disability Index (ODI). At the final follow-up, x-ray imaging was used to measure disc height (DH), slip percentage (SP), lumbar lordosis (LL), and slip angle (SA) at the surgical segment. Interbody fusion status was assessed based on the Bridwell grading criteria.

ULIF surgery for lumbar spondylolisthesis with navigation assistance yields favorable early outcomes, including reduced surgery duration, fewer fluoroscopy instances, lower intraoperative blood loss, and less postoperative drainage volume (P < 0.05). Patients in the navigation group also show greater early postoperative improvements in low back pain (P < 0.05). No significant differences were observed between the two groups in other evaluation indicators (P > 0.05).

Compared with the non-navigation group, the ULIF procedure guided by the two-dimensional integrated navigation system—which is simple and effective—can provide better early relief of low back pain in patients with lumbar spondylolisthesis, while also shortening operative time, reducing the number of fluoroscopy instances, minimizing intraoperative blood loss, and decreasing postoperative drainage volume. This surgical approach demonstrates great potential for widespread clinical application.

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