Analysis Of Position And Grade Of Screw Perforation In Minimally Invasive Transforaminal Lumbar Interbody Fusion With Intraoperative Opto-magnetic Navigation

[Objective] : To compare the position and the grade of screw perforation in Quadrant system-assisted minimally invasive transforaminal lumbar interhodv fusion(MISTLIF)with opto-magnetic navigation and Ooptical navigation for degenerative lumbar disease.[Methods]: Clinical date were collected from 100 patients who underwent MISTLIF in the First Affiliated Hospital of Hainan Medical University from june 2019 to November 2020.Based on the different techniques used for pedicle screw insertion,30 patients had pedicle screw inserted by Opto-magnetic navigation,while the remaining 70 patients had screw placed by Optical navigation.The perioperative complications,single screw insertion time and bleeding were recorded in the two groups of patients.The accuracy of pedicle screw placement was evaluated by using RAO.scales on CT images.[Results]: There are 30 cases in opto-magnetic navigation group which had a total of 156 screw placed assisted by opto-magnetic navigation system.And 70 cases in the ordinary optical group which had a total of 322 screw placed assisted by optical navigation system.It is not statistically significant and comparable in two groups in age,gender,preoperative diagnosis and surgical segment composition ratio.All of the patients completed the operation successfully without major blood vessel,nerve injury and other complications,and the safety rate was 100%.Postoperatively,based on CT images,using the RAO.grading standard,it was found that the pedicle screw placement rate of 0 and 1 in the opto-magnetic navigation group(penetrating cortex <2mm)was 93%,which was higher than 91% in the optical navigation group;In the opto-magnetic navigation,the ratios of MCP,LCP,ACP were 2.6%,0.6%,and5.8%,respectively,which were lower than those of the optical navigation group by3.1%,1.2%,and 7.1%;but there was no statistical difference between the two groups.The pedicle screw placement rate of opto-magnetic navigation navigation at level 2 and level 3(penetrating cortex ≥2mm)is 3.8% and 3.2% are less than 5% and4% in the optical navigation group,but only the difference in the rate of level 3 is statistically significant.The postoperative VAS and ODI scores of the two groups were significantly improved compared with those before the operation,but the difference between the two was not statistically significant(P<0.05).[Conclusion]: Although there is no a statistical difference between the excellent and good rate of opto-magnetic navigation and optical navigation,the opto-magnetic navigation can improve the minimally invasive transforaminal approach lumbar interbody fusion pedicle screw placement through intraoperative optical and magnetic mutual verification.Opto-magnetic navigation has certain clinical application value because it is better than optical navigation in cortical breaking rate and level 3.