O‐Arm Navigated MIS‐TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet Joint

ABSTRACT Objective O‐arm navigated MIS‐TLIF is one of the novel surgical techniques for treating lumbar spondylolisthesis, but there still lacks enough evidence regarding intraoperative facet joint violation (FJV) and postoperative facet joint degeneration (FJD). This study aimed to compare clinical...

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Main Authors: Yuhao Yang, Qingshuang Zhou, Xiaojiang Pu, Zhentao Zhang, Kai Sun, Bin Wang, Zezhang Zhu, Yong Qiu, Xu Sun
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Orthopaedic Surgery
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Online Access:https://doi.org/10.1111/os.70044
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author Yuhao Yang
Qingshuang Zhou
Xiaojiang Pu
Zhentao Zhang
Kai Sun
Bin Wang
Zezhang Zhu
Yong Qiu
Xu Sun
author_facet Yuhao Yang
Qingshuang Zhou
Xiaojiang Pu
Zhentao Zhang
Kai Sun
Bin Wang
Zezhang Zhu
Yong Qiu
Xu Sun
author_sort Yuhao Yang
collection DOAJ
description ABSTRACT Objective O‐arm navigated MIS‐TLIF is one of the novel surgical techniques for treating lumbar spondylolisthesis, but there still lacks enough evidence regarding intraoperative facet joint violation (FJV) and postoperative facet joint degeneration (FJD). This study aimed to compare clinical outcomes, accuracy of screw placement, and supradjacent FJV between the O‐arm navigated MIS‐TLIF group (NavMIS‐TLIF group) and the open‐TLIF group for the treatment of low‐grade lumbar spondylolisthesis, and further, to investigate the risk factors influencing FJD. Methods We retrospectively reviewed a cohort of patients with low‐grade lumbar spondylolisthesis who had received O‐Arm navigated MIS‐TLIF or open TLIF from May 2018 to May 2023. All the patients were followed up for at least 1 year. The demographic and perioperative data were recorded. The ODI and VAS scores were collected before surgery, 3 months postoperatively, and at the final follow‐up. Slip parameters were measured before surgery and at the last follow‐up. The screw convergence angle at the upper instrumented vertebra was evaluated based on postoperative CT images. Accuracy of screw placement and supradjacent FJV were assessed after surgery. The FJD was assessed at the final follow‐up in comparison to that before surgery. Results Each group had 42 patients. VAS back pain of the NavMIS‐TLIF group at the 3‐month follow‐up was lower than that of the open‐TLIF group, yet there was no significant difference in ODI and VAS scores between the groups at the final follow‐up. Both groups had similar slip reduction results. The clinically accurate rate of screw placement in the NavMIS‐TLIF group was 99.4%, significantly higher than 94.0% in the open‐TLIF group. At the upper instrumented vertebra, the screw convergence angle of the NavMIS‐TLIF group was significantly larger than that of the open‐TLIF group. The incidence of FJV in the NavMIS‐TLIF group (23.8%) was significantly lower than that in the open‐TLIF group (53.6%). There was no significant difference in preoperative FJD between the two groups, while at the last follow‐up, the open‐TLIF group had more cases of FJD. The screw convergence angle had a negative correlation with FJV and the aggravation of FJD, and FJV was positively associated with the aggravation of FJD. Multivariable logistic regression showed that FJV served as an independent risk factor for the aggravation of FJD. Conclusions O‐arm navigated MIS‐TLIF has similar clinical outcomes and higher accuracy of screw placement compared to open TLIF. O‐arm navigated MIS‐TLIF reduces the incidence of FJV significantly, which probably helps to delay FJD.
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spelling doaj-art-371c629f737c4fcaa90ac3199e7631372025-08-20T03:09:57ZengWileyOrthopaedic Surgery1757-78531757-78612025-06-011761710172010.1111/os.70044O‐Arm Navigated MIS‐TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet JointYuhao Yang0Qingshuang Zhou1Xiaojiang Pu2Zhentao Zhang3Kai Sun4Bin Wang5Zezhang Zhu6Yong Qiu7Xu Sun8Division of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing ChinaDivision of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDivision of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDivision of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDivision of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDivision of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDivision of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDivision of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing ChinaDivision of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing ChinaABSTRACT Objective O‐arm navigated MIS‐TLIF is one of the novel surgical techniques for treating lumbar spondylolisthesis, but there still lacks enough evidence regarding intraoperative facet joint violation (FJV) and postoperative facet joint degeneration (FJD). This study aimed to compare clinical outcomes, accuracy of screw placement, and supradjacent FJV between the O‐arm navigated MIS‐TLIF group (NavMIS‐TLIF group) and the open‐TLIF group for the treatment of low‐grade lumbar spondylolisthesis, and further, to investigate the risk factors influencing FJD. Methods We retrospectively reviewed a cohort of patients with low‐grade lumbar spondylolisthesis who had received O‐Arm navigated MIS‐TLIF or open TLIF from May 2018 to May 2023. All the patients were followed up for at least 1 year. The demographic and perioperative data were recorded. The ODI and VAS scores were collected before surgery, 3 months postoperatively, and at the final follow‐up. Slip parameters were measured before surgery and at the last follow‐up. The screw convergence angle at the upper instrumented vertebra was evaluated based on postoperative CT images. Accuracy of screw placement and supradjacent FJV were assessed after surgery. The FJD was assessed at the final follow‐up in comparison to that before surgery. Results Each group had 42 patients. VAS back pain of the NavMIS‐TLIF group at the 3‐month follow‐up was lower than that of the open‐TLIF group, yet there was no significant difference in ODI and VAS scores between the groups at the final follow‐up. Both groups had similar slip reduction results. The clinically accurate rate of screw placement in the NavMIS‐TLIF group was 99.4%, significantly higher than 94.0% in the open‐TLIF group. At the upper instrumented vertebra, the screw convergence angle of the NavMIS‐TLIF group was significantly larger than that of the open‐TLIF group. The incidence of FJV in the NavMIS‐TLIF group (23.8%) was significantly lower than that in the open‐TLIF group (53.6%). There was no significant difference in preoperative FJD between the two groups, while at the last follow‐up, the open‐TLIF group had more cases of FJD. The screw convergence angle had a negative correlation with FJV and the aggravation of FJD, and FJV was positively associated with the aggravation of FJD. Multivariable logistic regression showed that FJV served as an independent risk factor for the aggravation of FJD. Conclusions O‐arm navigated MIS‐TLIF has similar clinical outcomes and higher accuracy of screw placement compared to open TLIF. O‐arm navigated MIS‐TLIF reduces the incidence of FJV significantly, which probably helps to delay FJD.https://doi.org/10.1111/os.70044facet joint degenerationfacet joint violationlumbar spondylolisthesisMIS‐TLIFO‐arm navigation
spellingShingle Yuhao Yang
Qingshuang Zhou
Xiaojiang Pu
Zhentao Zhang
Kai Sun
Bin Wang
Zezhang Zhu
Yong Qiu
Xu Sun
O‐Arm Navigated MIS‐TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet Joint
Orthopaedic Surgery
facet joint degeneration
facet joint violation
lumbar spondylolisthesis
MIS‐TLIF
O‐arm navigation
title O‐Arm Navigated MIS‐TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet Joint
title_full O‐Arm Navigated MIS‐TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet Joint
title_fullStr O‐Arm Navigated MIS‐TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet Joint
title_full_unstemmed O‐Arm Navigated MIS‐TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet Joint
title_short O‐Arm Navigated MIS‐TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet Joint
title_sort o arm navigated mis tlif avoids violation and delays degeneration of the supradjacent facet joint
topic facet joint degeneration
facet joint violation
lumbar spondylolisthesis
MIS‐TLIF
O‐arm navigation
url https://doi.org/10.1111/os.70044
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