Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study

Abstract Background Degenerative lumbar diseases (LDD) are increasingly common among the elderly due to extended life expectancy. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a preferred surgical technique for LDD, offering advantages over traditional methods, although it...

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Main Authors: Kangheng Niu, Zhenzhen Tao, Le Cheng, Zhong Wei, Hui Kang, Tanjun Wei, Biwang Huang, Feng Xu, Chengjie Xiong
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-06111-5
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author Kangheng Niu
Zhenzhen Tao
Le Cheng
Zhong Wei
Hui Kang
Tanjun Wei
Biwang Huang
Feng Xu
Chengjie Xiong
author_facet Kangheng Niu
Zhenzhen Tao
Le Cheng
Zhong Wei
Hui Kang
Tanjun Wei
Biwang Huang
Feng Xu
Chengjie Xiong
author_sort Kangheng Niu
collection DOAJ
description Abstract Background Degenerative lumbar diseases (LDD) are increasingly common among the elderly due to extended life expectancy. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a preferred surgical technique for LDD, offering advantages over traditional methods, although it presents technical challenges. In this study, we compared the clinical outcomes and radiological accuracy between optical navigation-assisted MIS-TLIF (OMIS-TLIF) and conventional C-arm navigation-assisted MIS-TLIF (CMIS-TLIF) for the treatment of LDD. Methods A retrospective analysis was conducted on 90 patients who underwent single-level lumbar fusion between December 2021 and April 2023. Patients were divided into two groups: 36 underwent OMIS-TLIF, and 54 underwent CMIS-TLIF. The surgical duration, blood loss, hospital stay, complication rates, and clinical outcomes were assessed. Radiological parameters, such as pedicle screw placement accuracy and facet joint violation (FJV) rates, were also evaluated. The learning curves for surgical time were analyzed using the Cumulative Sum Control Chart method. Results OMIS-TLIF demonstrated a significantly shorter total operation time (125.25 ± 19.51 min) compared with CMIS-TLIF (136.41 ± 20.39 min, P < 0.05). OMIS-TLIF also achieved higher accuracy in pedicle screw placement (99.31% vs. 96.76%, P < 0.05) and lower FJV rates (91.67% vs. 81.48%, P < 0.05). Significantly lower pain scores (VAS) and improved functional outcomes (ODI) was observed at the 1-week follow-up (P < 0.05), although no significant differences were noted at the 3-month and latest follow-ups. The learning curve for OMIS-TLIF showed proficiency after 14 cases, whereas CMIS-TLIF required 27 cases to achieve similar proficiency. Conclusion The optical navigation system enhances the precision and efficiency of MIS-TLIF. OMIS-TLIF demonstrated superior clinical outcomes compared with CMIS-TLIF, with improved accuracy of instrument placement, a shorter surgery times and learning curve. These findings suggest that OMIS-TLIF offers significant advantages for the treatment of LDD.
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publisher BMC
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series Journal of Orthopaedic Surgery and Research
spelling doaj-art-43ed059c3dce42ffbbd2d0d1e1c2acbd2025-08-20T03:43:10ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-07-0120111310.1186/s13018-025-06111-5Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective studyKangheng Niu0Zhenzhen Tao1Le Cheng2Zhong Wei3Hui Kang4Tanjun Wei5Biwang Huang6Feng Xu7Chengjie Xiong8Department of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaDepartment of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaDepartment of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaDepartment of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaDepartment of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaDepartment of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaDepartment of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaDepartment of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaDepartment of Orthopedics, General Hospital of Central Theater Command of the PLA of ChinaAbstract Background Degenerative lumbar diseases (LDD) are increasingly common among the elderly due to extended life expectancy. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a preferred surgical technique for LDD, offering advantages over traditional methods, although it presents technical challenges. In this study, we compared the clinical outcomes and radiological accuracy between optical navigation-assisted MIS-TLIF (OMIS-TLIF) and conventional C-arm navigation-assisted MIS-TLIF (CMIS-TLIF) for the treatment of LDD. Methods A retrospective analysis was conducted on 90 patients who underwent single-level lumbar fusion between December 2021 and April 2023. Patients were divided into two groups: 36 underwent OMIS-TLIF, and 54 underwent CMIS-TLIF. The surgical duration, blood loss, hospital stay, complication rates, and clinical outcomes were assessed. Radiological parameters, such as pedicle screw placement accuracy and facet joint violation (FJV) rates, were also evaluated. The learning curves for surgical time were analyzed using the Cumulative Sum Control Chart method. Results OMIS-TLIF demonstrated a significantly shorter total operation time (125.25 ± 19.51 min) compared with CMIS-TLIF (136.41 ± 20.39 min, P < 0.05). OMIS-TLIF also achieved higher accuracy in pedicle screw placement (99.31% vs. 96.76%, P < 0.05) and lower FJV rates (91.67% vs. 81.48%, P < 0.05). Significantly lower pain scores (VAS) and improved functional outcomes (ODI) was observed at the 1-week follow-up (P < 0.05), although no significant differences were noted at the 3-month and latest follow-ups. The learning curve for OMIS-TLIF showed proficiency after 14 cases, whereas CMIS-TLIF required 27 cases to achieve similar proficiency. Conclusion The optical navigation system enhances the precision and efficiency of MIS-TLIF. OMIS-TLIF demonstrated superior clinical outcomes compared with CMIS-TLIF, with improved accuracy of instrument placement, a shorter surgery times and learning curve. These findings suggest that OMIS-TLIF offers significant advantages for the treatment of LDD.https://doi.org/10.1186/s13018-025-06111-5Comprehensive workflow navigationOptical navigationMIS-TLIFSurgical accuracy and efficiency
spellingShingle Kangheng Niu
Zhenzhen Tao
Le Cheng
Zhong Wei
Hui Kang
Tanjun Wei
Biwang Huang
Feng Xu
Chengjie Xiong
Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study
Journal of Orthopaedic Surgery and Research
Comprehensive workflow navigation
Optical navigation
MIS-TLIF
Surgical accuracy and efficiency
title Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study
title_full Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study
title_fullStr Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study
title_full_unstemmed Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study
title_short Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study
title_sort comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion a retrospective study
topic Comprehensive workflow navigation
Optical navigation
MIS-TLIF
Surgical accuracy and efficiency
url https://doi.org/10.1186/s13018-025-06111-5
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