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Purpose <p>The aim of this study is to present our experience with oblique lateral interbody fusion combined with percutaneous bilateral pedicle screw fixation (OLIF + PPSF) performed under C-arm assistance in a single-position lateral decubitus position, and to report the accuracy of screw placement.</p> Methods <p>A prospective analysis was conducted on patients undergoing OLIF+PPSF by a single surgical team between October 2021 and November 2023. Patients were categorized into single-position or dual-position groups based on intraoperative positioning for screw insertion. Data collected included demographics, operative duration, blood loss, and complications. Clinical outcomes were assessed using ODI and VAS scores. Radiographic assessments included segmental lordosis (SL), lumbar lordosis (LL), and CT-based screw accuracy grading.</p> Results <p>The single-position group included 47 patients (80 levels), and the dual-position group 44 patients (71 levels). The single-position group had a significantly shorter mean operative time (<i>P</i> &lt; 0.05). Postoperative CT revealed an overall screw accuracy of 98% in the single-position group, with no significant difference from the dual-position group. All suboptimal screws (5/248, Grade B/C) occurred within the first 18 cases, none requiring revision or causing neurological symptoms. A learning curve analysis identified 18 cases as the inflection point for operative time stabilization. Both SL and LL improved significantly postoperatively, with no difference between groups.</p> Conclusion <p>Our experience demonstrates that although screw placement time was relatively longer and accuracy relatively lower during the initial phase of the learning curve for single-position lateral decubitus screw insertion, this was associated with the surgeon’s adaptation process. After 18 cases, both screw placement time and accuracy significantly improved. This technique avoids intraoperative repositioning, reduces operative time, improves surgical efficiency, and demonstrates high reproducibility, making it suitable for widespread adoption.</p>

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A retrospective review of single-position lateral decubitus oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation cases: early learning curve and screw placement accuracy

  • 期刊论文

  • 发表日期：

    2026年2月2日

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  • Yuan Gao,
  • Yanbing Liu,
  • Zhenfang Gu,
  • Zhengqi Zhao,
  • Fengyu Liu,
  • Zhao Liu,
  • Xianze Sun

摘要

Purpose

The aim of this study is to present our experience with oblique lateral interbody fusion combined with percutaneous bilateral pedicle screw fixation (OLIF + PPSF) performed under C-arm assistance in a single-position lateral decubitus position, and to report the accuracy of screw placement.

Methods

A prospective analysis was conducted on patients undergoing OLIF+PPSF by a single surgical team between October 2021 and November 2023. Patients were categorized into single-position or dual-position groups based on intraoperative positioning for screw insertion. Data collected included demographics, operative duration, blood loss, and complications. Clinical outcomes were assessed using ODI and VAS scores. Radiographic assessments included segmental lordosis (SL), lumbar lordosis (LL), and CT-based screw accuracy grading.

Results

The single-position group included 47 patients (80 levels), and the dual-position group 44 patients (71 levels). The single-position group had a significantly shorter mean operative time (P < 0.05). Postoperative CT revealed an overall screw accuracy of 98% in the single-position group, with no significant difference from the dual-position group. All suboptimal screws (5/248, Grade B/C) occurred within the first 18 cases, none requiring revision or causing neurological symptoms. A learning curve analysis identified 18 cases as the inflection point for operative time stabilization. Both SL and LL improved significantly postoperatively, with no difference between groups.

Conclusion

Our experience demonstrates that although screw placement time was relatively longer and accuracy relatively lower during the initial phase of the learning curve for single-position lateral decubitus screw insertion, this was associated with the surgeon’s adaptation process. After 18 cases, both screw placement time and accuracy significantly improved. This technique avoids intraoperative repositioning, reduces operative time, improves surgical efficiency, and demonstrates high reproducibility, making it suitable for widespread adoption.