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Transfacet screws using spinal navigation in addition to anterior or oblique lumbar interbody fusion: technical note and preliminary results

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Abstract

Transfacet screws (TFS) are an alternative to the classic bilateral pedicular screws (BPS) in addition to anterior (ALIF) or oblique (OLIF) lumbar interbody fusion. Spinal navigation could help the surgeon in technically demanding procedures in order to avoid screw malposition. Although spinal navigation is commonly used in BPS, its contribution in TFS remains unclear. Our aim here was to assess the feasibility of TFS using spinal navigation in addition to anterior lumbar fusion. Five patients suffering from lumbar degenerative disc disease were included. During the same general anaesthesia, we performed successively an ALIF or OLIF and then a TFS according to Boucher technique using spinal navigation (O-arm). No peri-operative complication occurred, and all the screws were successfully positioned (n = 10). All clinical scores (ODI, VAS L and VAS R) improved at 6-month follow-up. Segmental lordosis increased from 6° [2.4°–12°] to 13.6° [8°–17°]. Fusion was achieved for the five patients. TFS using O-arm in addition to ALIF/OLIF is feasible. To confirm our early favourable outcomes on clinical and radiological data, this technique must be evaluated on larger samples of patients.

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Abbreviations

ALIF:

Anterior lumbar interbody fusion

BPS:

Bipedicular screw

CT:

Computed tomography

ISA:

Interspinous anchor

ODI:

Oswestry disability index

OLIF:

Oblique lumbar interbody fusion

TFS:

Transfacet screw

VAS L:

Visual analog scale lumbar

VAS R:

Visual analog scale radicular

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Authors and Affiliations

  1. Spine Surgery Department, CHU de Nice, Hôpital Pasteur 2, 30 avenue de la voie Romaine, 06000, Nice, France

    Antoine Gennari, Amandine Gavotto & Stéphane Litrico

  2. Neurosurgery Department, CHU de Nice, Hôpital Pasteur 2, Nice, France

    Fabien Almairac & Philippe Paquis

  3. Université Côte d’Azur, Nice, France

    Antoine Gennari, Amandine Gavotto, Fabien Almairac, Yann Pelletier, Philippe Paquis & Stéphane Litrico

  4. Orthopedic Surgery Department, CHU de Nice, Hôpital Pasteur 2, Nice, France

    Yann Pelletier

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  1. Antoine Gennari
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  2. Amandine Gavotto
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Correspondence to Antoine Gennari.

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This work has not received any support from industries or institutions. Author SL is consultant for ZimmerBiomet, but has no conflict of interest to declare in connection with this work.

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Gennari, A., Gavotto, A., Almairac, F. et al. Transfacet screws using spinal navigation in addition to anterior or oblique lumbar interbody fusion: technical note and preliminary results. Eur J Orthop Surg Traumatol 31, 1523–1528 (2021). https://doi.org/10.1007/s00590-021-02878-5

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  • DOI: https://doi.org/10.1007/s00590-021-02878-5

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