A New Technique that Combines Navigation-Assisted Lateral Interbody Fusion and Percutaneous Placement of Pedicle Screws in the Lateral Decubitus Position with the Surgeon Using Wearable Smart Glasses: A Small Case Series and Technical Note

BACKGROUND: We describe a new technique that combines navigation-assisted extreme lateral interbody fusion (NALIF) and percutaneous placement of pedicle screws in the lateral decubitus position with the surgeon using wearable smart glasses. METHODS: We explain our method for nonfluoroscopic NALIF and single-position (SP)-percutaneous pedicle screw (PPS) surgery for patients with degenerative lumbar diseases using wearable smart glasses. The wearable smart glasses provide a semitransparent overlay of the navigation information onto the image seen through the lenses. This technique does not require fluoroscopy during lateral interbody fusion or PPS insertion. It is convenient because it does not require a Jamshidi needle or guidewire when inserting PPSs. RESULTS: Using this method, the surgeon can glance at the 3-dimensional images on the wearable smart glasses while still viewing the operation field. A review of 24 cases yielded an average operation time of 89.5 +/- 16.4 minutes and 66.7 +/- 67.0 mL of blood loss, without any severe intra-or postoperative complications. CONCLUSIONS: Nonfluoroscopic NALIF and SP-PPS placement surgery is a safe and effective means for implanting cages and PPSs in this minimally invasive approach without compromising the results. Although further investigations are needed, the wearable smart glasses may be a useful surgical aid when performing NALIF and SP-PPS placement in patients with degenerative lumbar diseases.