Awake Robotic Minimally Invasive Transforaminal Lumbar Interbody Fusion Under Spinal Anesthesia: A Prospective Study with 1-Year Follow-up.

Autor: De Biase G; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA., Akinduro OO; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA., Garcia D; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA., Bojaxhi E; Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida, USA., Buchanan IA; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA., Gruenbaum SE; Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida, USA., Forcht Dagi T; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA., Quinones-Hinojosa A; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA., Abode-Iyamah K; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA. Electronic address: abode-iyamah.kingsley@mayo.edu.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Sep; Vol. 189, pp. e941-e947. Date of Electronic Publication: 2024 Jul 08.
DOI: 10.1016/j.wneu.2024.07.044
Abstrakt: Background: We describe our protocol and outcomes of awake robotic minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) under spinal anesthesia.
Methods: We conducted a prospective study of 10 consecutive patients undergoing awake robotic single-level MIS-TLIF with the Mazor X robot. We prospectively collected patient-reported outcomes (back and leg pain visual analog scale and Oswestry Disability Index) preoperatively at 1-month and 1-year follow-ups and assessed fusion and screw placement accuracy with a 1-year computed tomography (CT) scan.
Results: Median age was 61 years (interquartile range [IQR] = 57.7-66). Median body mass index was 27 kg/m 2 . No intraoperative complications were reported. Most (9/10) patients were discharged home, and 50% discharged on the day of surgery. Median length of stay was 16.5 hours (IQR = 5-35.5). Median follow-up was 12.5 months (IQR = 12-13.5), with 9 patients having at least 12-month follow-up, with CT scans documenting good screw placement (Gertzbein-Robbins grade A) and solid bony fusion. Median preoperative back pain visual analog scale score was 7.8 (IQR = 6.9-8) versus 1.5 (IQR = 0-3.2) at 1-month post operation, P < 0.01, and 0 (IQR = 0-1) at 1-year follow-up, P < 0.01; median preoperative leg pain 8 (IQR = 7.4-8) versus 0 (IQR = 0-1.2) at 1-month post operation, P < 0.01, and 0 (IQR = 0-2) at 1-year follow-up, P < 0.01; median preoperative Oswestry Disability Index 47.5 (IQR = 27.8-57.5) versus 4 (IQR = 0-16) at 1-month postoperation, P < 0.01, and 0 (IQR = 0-7) at 1-year follow-up, P < 0.01. Median preoperative disk height of the index level was 8 mm (IQR = 2.4-9.5) versus 11.4 mm (IQR = 9.2-11.2) postoperatively,P < 0.01. Median preoperative lordosis of the index level was 5 degrees (IQR = 3.4-8.5) versus 10.1 degrees (7.3-12.2) postoperatively, P < 0.01.
Conclusions: Our study showed significant improvement in patient-reported outcomes at 1-month and 1-year follow-ups after awake robotic MIS-TLIF, as well as solid bony fusion on CT scans.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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