Navigated 2-level posterior lumbar fusion: a 5-cm-incision procedure

BACKGROUND: The current study presents a technique (navigated posterior lumbar fusion) which takes a 5-cm incision to accomplish a 2-level posterior lumbar fusion (PLF) and compared its efficacy and efficiency with those of conventional PLF. METHODS: Forty patients who were indicated for 2-level lumbar fusion were included and randomized to either navigated PLF group or conventional PLF group. Blood loss, operation time, incision length, complications, bed rest period, and length of hospitalization were recorded. Oswestry Disability Index (ODI) scoring was also performed for each patient before surgery, 3 months after surgery, and 2 years after surgery. RESULTS: The incision length was significantly shorter in the navigated PLF group than in the conventional PLF group (4.8 vs. 10.9 cm, p = 0.001). Accordingly, the blood loss was also significantly less in the navigated PLF group than in the conventional PLF group (209.0 vs. 334.0 ml, p = 0.047). There was no significant difference in total operation time between the two groups (160.7 vs. 144.4 min, p = 0.116). Compared to the conventional PLF group, the navigated PLF group showed significantly less postoperative blood loss, less time to mobilization, and shorter length of hospital stay. The ODI score improved significantly in the both groups immediately after surgery, and maintained well in the following 2 years. CONCLUSION: Compared to conventional PLF, navigated PLF proved to be superior with regard to incision length, blood loss, time to mobilization, and shorter length of hospital stay.