{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:39:39Z","timestamp":1791650379406,"version":"4.3.4"},"reference-count":27,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Purpose: Single-position surgery with patients in a lateral position, which involves inserting percutaneous pedicular screws (PPS) and lateral interbody fusion (LIF) to avoid changing the position, has been reported. The purpose of the present study was to evaluate the utility and appropriateness of single-position LIF-PPS using O-arm-based navigation in the innovative oblique position. Methods: This study involved a retrospective analysis of 92 consecutive patients with lumbar spondylolisthesis who underwent LIF-PPS using O-arm-based navigation. Thirty-five subjects demonstrated surgery with repositioning, as well as 24 in the lateral decubitus position, and 33 in the oblique during PPS, where the position was changed to the lateral decubitus position using bed rotation without resetting. We compared these three groups in terms of the surgery time, blood loss, and the accuracy of the screw placement. Results: The operative time was significantly shorter in the single-position surgery, both in the lateral and oblique positions, compared to surgery in a dual position. The blood loss was significantly increased in the lateral position compared to the dual and oblique positions. The screw trajectory angle on the downside was significantly smaller in the lateral position, and the accuracy of the screw placement on the downside was significantly lower in the lateral position compared to the dual and oblique positions. Conclusion: Single-position surgery could reduce the average surgery time by about 60\u2009min. The present study indicated the oblique position during PPS insertion might make single-position surgery more useful to improve the accuracy of PPS on the downside, with less blood loss.<\/jats:p>","DOI":"10.3390\/jcm12227114","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T10:57:46Z","timestamp":1700045866000},"page":"7114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Utility and Appropriateness of Single-Position Circumferential Lumbar Interbody Fusion Using O-Arm-Based Navigation in the Novel Oblique Position"],"prefix":"10.3390","volume":"12","author":[{"given":"Tetsuro","family":"Ohba","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi 409-3898, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi 409-3898, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi 409-3898, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5630-9600","authenticated-orcid":false,"given":"Hirotaka","family":"Haro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi 409-3898, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/01.BRS.0000107007.31714.77","article-title":"A prospective, randomized controlled clinical trial of anterior lumbar interbody fusion using a titanium cylindrical threaded fusion device","volume":"29","author":"Sasso","year":"2004","journal-title":"Spine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"471","DOI":"10.3171\/2009.5.SPINE08633","article-title":"Surgical site infection rates after minimally invasive spinal surgery","volume":"11","author":"Eichholz","year":"2009","journal-title":"J. Neurosurg. Spine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1177\/2192568221994794","article-title":"Radiological Assessment of Postoperative Paraspinal Muscle Changes After Lumbar Interbody Fusion with or Without Minimally Invasive Techniques","volume":"13","author":"Kameyama","year":"2023","journal-title":"Glob. Spine J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1007\/s00586-015-3840-2","article-title":"Comparison of clinical outcomes following minimally invasive lateral interbody fusion stratified by preoperative diagnosis","volume":"24","author":"Khajavi","year":"2015","journal-title":"Eur. Spine J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/s00586-015-3946-6","article-title":"Central and foraminal indirect decompression in MIS lateral interbody fusion (XLIF): Video lecture","volume":"24","author":"Elowitz","year":"2015","journal-title":"Eur. Spine J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Ohba, T., Ebata, S., and Haro, H. (2017). Comparison of serum markers for muscle damage, surgical blood loss, postoperative recovery, and surgical site pain after extreme lateral interbody fusion with percutaneous pedicle screws or traditional open posterior lumbar interbody fusion. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-017-1775-y"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/BSD.0b013e318268007b","article-title":"Does Prone Repositioning Before Posterior Fixation Produce Greater Lordosis in Lateral Lumbar Interbody Fusion (LLIF)?","volume":"27","author":"Yson","year":"2014","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/BRS.0000000000002330","article-title":"MIS Single-position Lateral and Oblique Lateral Lumbar Interbody Fusion and Bilateral Pedicle Screw Fixation","volume":"43","author":"Blizzard","year":"2018","journal-title":"Spine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1007\/s00586-020-06388-6","article-title":"Simultaneous single-position lateral interbody fusion and percutaneous pedicle screw fixation using O-arm-based navigation reduces the occupancy time of the operating room","volume":"29","author":"Ouchida","year":"2020","journal-title":"Eur. Spine J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.spinee.2020.11.002","article-title":"Single position circumferential fusion improves operative efficiency, reduces complications and length of stay compared with traditional circumferential fusion","volume":"21","author":"Buckland","year":"2020","journal-title":"Spine J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1007\/s00586-023-07591-x","article-title":"Minimally invasive lateral single-position surgery for multilevel degenerative lumbar spine disease: Feasibility and perioperative results in a single Latin-American spine center","volume":"32","author":"Romero","year":"2023","journal-title":"Eur. Spine J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.14444\/8231","article-title":"Single-Position Fluoroscopy-Guided Lateral Lumbar Interbody Fusion with Intraoperative Computed Tomography\u2013Navigated Posterior Pedicle Screw Fixation: Technical Report and Literature Review","volume":"16","author":"Goldberg","year":"2022","journal-title":"Int. J. Spine Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e379","DOI":"10.1016\/j.wneu.2021.04.039","article-title":"Single-Position Surgery versus Lateral-Then-Prone-Position Circumferential Lumbar Interbody Fusion: A Systematic Literature Review","volume":"151","author":"Guiroy","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jocn.2020.06.016","article-title":"Facet joint violation after single-position versus dual-position lateral interbody fusion and percutaneous pedicle screw fixation: A comparison of two techniques","volume":"78","author":"Hiyama","year":"2020","journal-title":"J. Clin. Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1007\/s00586-016-4489-1","article-title":"Percutaneous pedicle screw placements: Accuracy and rates of cranial facet joint violation using conventional fluoroscopy compared with intraoperative three-dimensional computed tomography computer navigation","volume":"25","author":"Ohba","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1007\/s00586-011-1892-5","article-title":"Factors affecting the accurate placement of percutaneous pedicle screws during minimally invasive transforaminal lumbar interbody fusion","volume":"20","author":"Kim","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2800","DOI":"10.1097\/01.brs.0000192297.07709.5d","article-title":"The clinical risk of vertebral artery injury from cervical pedicle screws inserted in degenerative vertebrae","volume":"30","author":"Neo","year":"2005","journal-title":"Spine"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Pojski\u0107, M., Bopp, M., Sa\u00df, B., Kirschbaum, A., Nimsky, C., and Carl, B. (2021). Intraoperative Computed Tomography-Based Navigation with Augmented Reality for Lateral Approaches to the Spine. Brain Sci., 11.","DOI":"10.3390\/brainsci11050646"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Tan, Y., Tanaka, M., Sonawane, S., Uotani, K., Oda, Y., Fujiwara, Y., Arataki, S., Yamauchi, T., Takigawa, T., and Ito, Y. (2021). Comparison of Simultaneous Single-Position Oblique Lumbar Interbody Fusion and Percutaneous Pedicle Screw Fixation with Posterior Lumbar Interbody Fusion Using O-arm Navigated Technique for Lumbar Degenerative Diseases. J. Clin. Med., 10.","DOI":"10.21203\/rs.3.rs-968619\/v1"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e489","DOI":"10.1016\/j.wneu.2020.04.052","article-title":"Comparison of Radiation Exposure Between O-Arm Navigated and C-Arm Guided Screw Placement in Minimally Invasive Transforaminal Lumbar Interbody Fusion","volume":"139","author":"Chang","year":"2020","journal-title":"World Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"351","DOI":"10.5312\/wjo.v6.i3.351","article-title":"Complications associated with prone positioning in elective spinal surgery","volume":"6","author":"DePasse","year":"2015","journal-title":"World J. Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"292","DOI":"10.9738\/INTSURG-D-13-00256.1","article-title":"The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines","volume":"100","author":"Kwee","year":"2015","journal-title":"Int. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"162","DOI":"10.21037\/jss-21-13","article-title":"One surgeon\u2019s learning curve with single position lateral lumbar interbody fusion: Perioperative outcomes and complications","volume":"7","author":"Warren","year":"2021","journal-title":"J. Spine Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"20","DOI":"10.31616\/asj.2020.0526","article-title":"Accuracy of Percutaneous Pedicle Screw Placement after Single-Position versus Dual-Position Insertion for Lateral Interbody Fusion and Pedicle Screw Fixation Using Fluoroscopy","volume":"16","author":"Hiyama","year":"2022","journal-title":"Asian Spine J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.clineuro.2018.10.013","article-title":"Simultaneous lateral interbody fusion and pedicle screws (SLIPS) with CT-guided navigation","volume":"175","author":"Sellin","year":"2018","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1007\/s00586-022-07229-4","article-title":"Single-position circumferential lumbar spinal fusion: An overview of terminology, concepts, rationale and the current evidence base","volume":"31","author":"Thomas","year":"2022","journal-title":"Eur. Spine J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"E1463","DOI":"10.1097\/BRS.0000000000002737","article-title":"Pedicle Perforation While Inserting Screws Using O-arm Navigation During Surgery for Adolescent Idiopathic Scoliosis","volume":"43","author":"Oba","year":"2018","journal-title":"Spine"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/22\/7114\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:23:33Z","timestamp":1760131413000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/22\/7114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,15]]},"references-count":27,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["jcm12227114"],"URL":"https:\/\/doi.org\/10.3390\/jcm12227114","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,15]]}}}