Background: Conventional L5 corpectomy requires a large incision and an extended period of intraoperative fluoroscopy. We describe herein a new L5 corpectomy technique. Methods: A 79-year-old woman was referred to our hospital for leg pain and lower back pain due to an L5 vertebral fracture. Her daily life had been affected by severe lower back pain and sciatica for more than 2 months. We initially performed simple decompression surgery, but this proved effective for only 10 months. Results: For revision surgery, the patient underwent minimally invasive L5 corpectomy with a navigated expandable cage without fluoroscopy. The second surgery took 215 min, and estimated blood loss was 750 milliliters. The revision surgery proved successful, and the patient could then walk using a cane. In terms of clinical outcomes, the Oswestry Disability Index improved from 66% to 24%, and the visual analog scale score for lower back pain improved from 84 to 31 mm at the 1-year follow-up. Conclusions: Minimally invasive L5 corpectomy with a navigated expandable vertebral cage is effective for reducing cage misplacement and surgical invasiveness. With this new technique, surgeons and operating room staff can avoid the risk of adverse events due to intraoperative radiation exposure.

中文翻译：

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带导航可扩展椎骨笼的微创 L5 椎体切除术：技术说明

背景：传统的 L5 椎体切除术需要大切口和较长时间的术中透视。我们在此描述了一种新的 L5 椎体切除技术。方法： 一名 79 岁女性因 L5 椎体骨折导致腿部疼痛和腰部疼痛被转诊至我院。她的日常生活受到严重的腰痛和坐骨神经痛影响超过 2 个月。我们最初进行了简单的减压手术，但事实证明这仅在 10 个月内有效。结果：对于翻修手术，患者接受了微创 L5 椎体切除术，并在没有透视的情况下使用了导航可扩张笼。第二次手术耗时 215 分钟，估计失血量为 750 毫升。翻修手术证明是成功的，然后患者可以用手杖走路。在临床结果方面，在 1 年的随访中，Oswestry 残疾指数从 66% 提高到 24%，腰痛的视觉模拟量表评分从 84 毫米提高到 31 毫米。结论：微创 L5 椎体切除术与导航可扩展椎体融合器可有效减少椎体融合器错位和手术侵入性。借助这项新技术，外科医生和手术室工作人员可以避免因术中辐射暴露而导致的不良事件风险。