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Accuracy of the lateral cage placement under intraoperative C-arm fluoroscopy in oblique lateral interbody fusion

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dc.contributor.authorChung, NS-
dc.contributor.authorLee, HD-
dc.contributor.authorJeon, CH-
dc.date.accessioned2019-11-13T04:27:40Z-
dc.date.available2019-11-13T04:27:40Z-
dc.date.issued2018-
dc.identifier.issn0949-2658-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/17604-
dc.description.abstractBACKGROUND: In oblique lateral interbody fusion (OLIF), the lateral cage enters into the disc space obliquely, and is then turned to the true lateral direction to achieve a lateral lumbar interbody fusion. The OLIF cage is sometimes placed asymmetrically although it seemed to be placed accurately on intraoperative C-arm images. The present study aimed to investigate the accuracy of cage placement and its effect on the radiological outcome in OLIF.
METHODS: This study involved a retrospective radiological analysis of 127 lateral cages in 75 consecutive OLIF patients. The cage deviations from the midline and cage obliquity were evaluated using three sets of images: (1) intraoperative C-arm fluoroscopy, (2) postoperative standing radiographs, and (3) postoperative computed tomography (CT).
RESULTS: The mean cage deviation from the midline was measured as 2.5 +/- 2.7 mm on intraoperative C-arm images, but was found to be more deviated on postoperative radiographs and CT (5.4 +/- 3.8 mm and 3.8 +/- 3.7 mm: P = 0.000 and 0.005, respectively). The cage obliquity on the intraoperative lateral C-arm was minimal in 26 (20.5%) cases, mild in 69 (54.3%), and moderate in 32 (25.2%), but was found to be more obliquely on postoperative radiographs as minimal in 9 (7.1%), mild in 55 (43.3%), and moderate in 63 (49.6%) (P < 0.001). Anterior/posterior disc heights, disc lordotic angle, fusion rate, and cage subsidence rate were not different according to cage obliquity (all P > 0.05).
CONCLUSIONS: Cage deviation from the midline and obliquity is underestimated on intraoperative C-arm images in OLIF. Although minimal cage deviation and obliquity did not affect the radiological outcome, great care should be made for the orthogonal cage insertion.
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dc.language.isoen-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHFemale-
dc.subject.MESHFluoroscopy-
dc.subject.MESHHumans-
dc.subject.MESHInternal Fixators-
dc.subject.MESHIntervertebral Disc Degeneration-
dc.subject.MESHLumbar Vertebrae-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSpinal Fusion-
dc.subject.MESHTomography, X-Ray Computed-
dc.subject.MESHTreatment Outcome-
dc.titleAccuracy of the lateral cage placement under intraoperative C-arm fluoroscopy in oblique lateral interbody fusion-
dc.typeArticle-
dc.identifier.pmid30119930-
dc.contributor.affiliatedAuthor정, 남수-
dc.contributor.affiliatedAuthor이, 한동-
dc.contributor.affiliatedAuthor전, 창훈-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.jos.2018.07.010-
dc.citation.titleJournal of orthopaedic science-
dc.citation.volume23-
dc.citation.number6-
dc.citation.date2018-
dc.citation.startPage918-
dc.citation.endPage922-
dc.identifier.bibliographicCitationJournal of orthopaedic science, 23(6). : 918-922, 2018-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1436-2023-
dc.relation.journalidJ009492658-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Orthopedic Surgery
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