The aim of the study was to compare the accuracy of percutaneous pedicle screw (PPS) insertion (P-side) with that of conventional open screw insertion (O-side) during unilateral open transforaminal lumbar interbody fusion (TLIF) in the same patients. We also sought to determine the incidence of pedicle screw misplacement and to identify relevant risk factors. The study was a retrospective analysis of prospectively collected data for 766 pedicle screws placed in 181 consecutive patients who underwent a unilateral open-TLIF procedure in the lumbosacral spine. Our minimally invasive TLIF was performed by unilateral open freehand insertion of pedicle screws for decompression on one side and PPS on the opposite side. Using this approach, we were able to compare the accuracy of PPS insertion with that of conventional open screw insertion in the same patients. There were 383 PPSs and 383 screws inserted by the open method. The accuracy of screw placement was evaluated on reconstructed computed tomography images obtained postoperatively, and screw misplacement was classified. Potential risk factors for screw misplacement were investigated in three-level mixed-effects logistic regression analysis. Thirty-four screws (8.9%) were misplaced on the P-side and 37 (9.5%) were misplaced on the O-side; the difference was not statistically significant (P = 0.803). Subclassification analysis revealed minor perforation of 28 screws (7.3%) on the P-side and 32 (8.4%) on the O-side, moderate perforation of 5 screws (1.3%) on the P-side and 4 (1.0%) on the O-side, and severe perforation of 1 screw (0.3%) on each side. Three-level mixed-effects logistic regression analysis identified body mass index as a significant risk factor for screw misplacement on the P-side (odds ratio 1.194, 95% confidence interval 1.066–1.338). Accuracy of pedicle screw insertion was not significantly different between PPS insertion and conventional open screw insertion in the same patients. Body mass index had a significant influence on the risk of screw misplacement in PPS insertion.

中文翻译：

---

椎弓根螺钉插入单侧开放式经椎间孔腰椎椎间融合术的准确性：同一患者经皮和常规开放技术的并排比较

该研究的目的是比较同一患者单侧开放式经椎间孔腰椎椎体间融合术（TLIF）时经皮椎弓根螺钉（PPS）插入（P侧）与常规开放螺钉插入（O侧）的准确性。我们还试图确定椎弓根螺钉错位的发生率，并确定相关的危险因素。这项研究是一项回顾性分析，前瞻性收集了181例在腰椎单侧开放式TLIF手术中接受治疗的766例椎弓根螺钉的数据。我们的微创TLIF通过单侧开放徒手插入椎弓根螺钉进行减压，在一侧进行减压，在另一侧进行PPS。使用这种方法，我们能够比较同一患者中PPS插入和传统开放式螺钉插入的准确性。通过打开方法插入了383 PPS和383螺钉。在术后获得的重建计算机断层扫描图像上评估螺钉放置的准确性，并对螺钉放置错误进行分类。在三级混合效应逻辑回归分析中研究了螺钉错位的潜在危险因素。在P侧放错了34个螺钉（8.9％），在O侧放错了37个（9.5％）。差异无统计学意义（P = 0.803）。子类别分析显示，P侧轻微穿孔28个螺钉（7.3％），O侧轻微穿孔32个（8.4％），P侧轻微穿孔5个螺钉（1.3％），P侧4个（1.0％） O面，并在每侧严重穿孔1颗螺丝（0.3％）。三级混合效应逻辑回归分析确定体重指数是P侧螺钉错位的重要危险因素（赔率1.194，95％置信区间1.066–1.338）。在同一患者中，PPS插入和传统的开放式螺钉插入之间，椎弓根螺钉插入的准确性没有显着差异。体重指数对PPS插入中螺钉错位的风险有重大影响。在同一患者中，PPS插入和传统的开放式螺钉插入之间，椎弓根螺钉插入的准确性没有显着差异。体重指数对PPS插入中螺钉错位的风险有重大影响。在同一患者中，PPS插入和传统的开放式螺钉插入之间，椎弓根螺钉插入的准确性没有显着差异。体重指数对PPS插入中螺钉错位的风险有重大影响。