Therapeutic effect of magnetic navigation aided endoscopic transforaminal lumbar interbody fusion on degenerative diseases of lumbar spine

English Keywords:Lumbar degenerative disease  Lumbar interbody fusion  Magnetic navigation  Spinal endoscopy

English Abstract:

  【Abstract】 Objectives: To observe the clinical effect of magnetic navigation aided endoscopic lumbar fusion for single-segment lumbar degenerative diseases(LDD). Methods: A retrospective analysis was performed on 43 patients with single-segment LDD treated with endoscopic lumbar fusion in our hospital from January 2021 to January 2022. The patients were divided into C-arm group(n=23) and magnetic navigation group(n=20). There were no significant difference in age, body mass index(BMI), duration of symptom, gender, segment, principal diagnosis and chronic disease between the two groups(P>0.05). The fluoroscopy times, screw implantation duration, screw placement accuracy, operative time, intraoperative blood loss, postoperative drainage, bed rest time, hospital stay and complication of the two groups were compared. The visual analogue scale(VAS) and Oswestry disability index(ODI) before surgery, at 1 month, 3 months and 1 year after surgery were compared between the two groups. Postoperative fusion was evaluated at 1 year after surgery. Results: The fluoroscopy times, screw implantation duration, screw placement accuracy, operative time, intraoperative blood loss and postoperative blood loss of the magnetic navigation group and the C-arm group were 19.95±9.01 times, 24.80±9.77min, 97.50%, 163.40±20.77min, 69.50±26.90mL, 86.25±22.82mL, and 55.87±7.23 times, 60.04±5.59min, 89.13%, 198.87±33.38min, 100.43±47.85mL, and 117.83±54.41mL. The magnetic navigation group was superior to the C-arm group(P<0.05). There was no significant difference in bed rest time, hospital stay and complication between the two groups(P>0.05). The VAS score of back pain at 1 month after surgery in the magnetic navigation group was significantly lower than that in the C-arm group(P<0.05), and there was no significant differences in back pain VAS score, leg pain pain VAS score and ODI between the two groups before surgery, at 3 months after surgery and 1 year after surgery(P>0.05). The VAS scores and ODl scores of back pain and leg pain in two groups were significantly improved at 1 month, 3 months and 1 year after surgery(P<0.05). Lumbar fusion was evaluated by CT 1 year after surgery. In the C-arm group, there were 17 cases of grade Ⅰ lumbar fusion, 6 cases of grade Ⅱ fusion; In the magnetic navigation group, there were 16 cases of grade Ⅰ fusion and 4 cases of grade Ⅱ fusion; And there was no statistical difference between the two groups(P>0.05). Conclusions: Magnetic navigation aided endoscopic lumbar fusion for the treatment of single-segment LDD has a satisfactory short-term effect, which is similar to the C-arm guided endoscopic lumbar fusion. It has the advantages of fewer fluoroscopy times, higher nail placement accuracy, and less trauma and bleeding.