Single position circumferential fusion improves operative efficiency, reduces complications and length of stay compared with traditional circumferential fusion

Single Position Lateral Lumbar Interbody Fusion With Posterior Instrumentation Utilizing Computer Navigation and Robotic Assistance: Retrospective case review and surgical technique considerations

“…Time under general anesthesia may contribute to increased rates of post-operative ileus and prolonged hospitalization in patients who undergo DP LLIF. 14 In the current study, there were no mal-positioned screws following posterior instrumentation with the patient placed in the lateral decubitus position. While SP LLIF using traditional techniques is considered safe, the rates of screw malposition and pedicle breach has been reported to be as high as 5%.…”

“…In terms of blood loss, the current study results were comparable to reports in the literature following SP circumferential fusion which did not use a robotic arm for posterior pedicle screw instrumentation. 14,[19][20][21] Prone positioning may increase intra-abdominal pressure which can contribute to higher blood loss when using DP techniques. Multiple studies have reported blood loss to be a risk factor for increased length of stay.…”

“…It may also compromise instrument and implant sterility while all the surgical drapes must be taken off, new surgical table needs to be brought in, and the patient needs to be repositioned and re-draped. 14 Rigid robotic arm can increase the efficiency of LLIF procedure by making it easier for the surgeon to place posterior percutaneous pedicle screw instrumentation while keeping the patient in lateral decubitus position. In this small retrospective cohort study, we evaluated the feasibility of "single position lateral" technique utilizing computer navigation and robotic assistance for posterior instrumentation placement.…”

“…It may also compromise instrument and implant sterility while all the surgical drapes must be taken off, new surgical table needs to be brought in, and the patient needs to be repositioned and re-draped. 14 …”

Robotic Guided Minimally Invasive Spine Surgery

“…Traditionally, after the interbody device is placed in LLIF and OLIF procedures in the lateral position, the patient is "flipped" to the prone position for pedicle screw instrumentation and posterior stabilization. Recent studies have begun to investigate the placement of posterior instrumentation in the lateral position, to avoid the "flip," and initial studies have demonstrated improved operative efficiency, less blood loss, and less postoperative ileus with single position lateral circumferential fusions [56].…”