Single-Position Extreme Lateral Lumbar Interbody Fusion with Percutaneous Pedicle Screw Fixation Utilizing O-arm Navigation

Single-Position Extreme Lateral Lumbar Interbody Fusion with Percutaneous Pedicle Screw Fixation Utilizing O-arm Navigation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Single-Position Extreme Lateral Lumbar Interbody Fusion with Percutaneous Pedicle Screw Fixation Utilizing O-arm Navigation Yasunobu Itoh, Ryo Kitagawa, Ryuzaburo Kanazawa, Yota Zushi, Takao Kono, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9178248/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective Extreme lateral interbody fusion (XLIF) provides indirect decompression of the spinal canal and nerve root foramen while preserving the vertebral structures. Intraoperative guidance during conventional XLIF with percutaneous pedicle screw fixation (PPSF) relies primarily on fluoroscopy, which can expose both surgical staff and the patient to radiation. The use of O-arm navigation during XLIF and PPSF is anticipated to improve accuracy and significantly reduce the risk of radiation. Methods Thirty-one XLIF and PPSF procedures were performed using O-arm navigation in a semi-lateral, single-position setup, including 23 single-level and eight two-level cases. Pathologies included 22 lumbar degenerative spondylolisthesis, seven canal stenosis, and two spondylolytic spondylolisthesis. The control group included 29 patients who underwent two-position XLIF with C-arm fluoroscopy. For each patient, we collated key parameters, including operative time, blood loss, JOA score, ODI, and radiation exposure/doses. Patients were placed in a semi-lateral position. PPSF was first performed under O-arm guidance; subsequently, disc preparation and cage insertion were navigation-assisted and verified by C-arm fluoroscopy. Results Operative time and blood loss were similar between the navigation XLIF and non-navigation XLIF groups. The navigation-XLIF group had a much shorter radiation time (13.01 ± 6.56 vs. 66.46 ± 24.62 s) and a lower radiation dose (1.66 ± 0.62 vs. 5.48 ± 3.01 mGy). Both groups showed notable postoperative improvements in JOA and ODI scores. Conclusion XLIF with O-arm navigation demonstrated practicality, reliability, accuracy, precise cage placement, and complication rates comparable to those of traditional methods. Enhanced anatomical visualization reduced radiation exposure among surgical personnel. Extreme lateral interbody fusion O-arm navigation Percutaneous pedicle screw fixation Radiation dose Radiation exposure Single-position surgery Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9178248","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":615231234,"identity":"d1f418c3-b5fb-48c2-9af8-02f297db1ee1","order_by":0,"name":"Yasunobu 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Navigation","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Extreme lateral interbody fusion, O-arm navigation, Percutaneous pedicle screw fixation, Radiation dose, Radiation exposure, Single-position surgery","lastPublishedDoi":"10.21203/rs.3.rs-9178248/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9178248/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective \u003c/strong\u003eExtreme lateral interbody fusion (XLIF) provides indirect decompression of the spinal canal and nerve root foramen while preserving the vertebral structures. Intraoperative guidance during conventional XLIF with percutaneous pedicle screw fixation (PPSF) relies primarily on fluoroscopy, which can expose both surgical staff and the patient to radiation. The use of O-arm navigation during XLIF and PPSF is anticipated to improve accuracy and significantly reduce the risk of radiation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eThirty-one XLIF and PPSF procedures were performed using O-arm navigation in a semi-lateral, single-position setup, including 23 single-level and eight two-level cases. Pathologies included 22 lumbar degenerative spondylolisthesis, seven canal stenosis, and two spondylolytic spondylolisthesis. The control group included 29 patients who underwent two-position XLIF with C-arm fluoroscopy. For each patient, we collated key parameters, including operative time, blood loss, JOA score, ODI, and radiation exposure/doses. Patients were placed in a semi-lateral position. PPSF was first performed under O-arm guidance; subsequently, disc preparation and cage insertion were navigation-assisted and verified by C-arm fluoroscopy. \u003cstrong\u003eResults \u003c/strong\u003eOperative time and blood loss were similar between the navigation XLIF and non-navigation XLIF groups. The navigation-XLIF group had a much shorter radiation time (13.01 ± 6.56 vs. 66.46 ± 24.62 s) and a lower radiation dose (1.66 ± 0.62 vs. 5.48 ± 3.01 mGy). Both groups showed notable postoperative improvements in JOA and ODI scores.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e XLIF with O-arm navigation demonstrated practicality, reliability, accuracy, precise cage placement, and complication rates comparable to those of traditional methods. 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