Single Position Lateral versus Prone Transpsoas Lateral Interbody Fusion Inclusive of L4-L5: A Single Surgeon Experience Examining Early Postoperative Outcomes.
Publication/Presentation Date
7-1-2024
Abstract
OBJECTIVE: The transpsoas lateral lumbar interbody fusion (LLIF) procedure is a minimally invasive lumbar spine approach that provides indirect neural decompression, improved sagittal alignment, and a high fusion rate. Typically accompanied by posterior pedicle screw insertion, there has been interest in performing LLIF in a single position to decrease cost and time under anesthesia. However, there is a paucity of direct comparisons between single-position LLIF via prone versus lateral decubitus positioning. Therefore, this study aims to compare the outcomes of a single surgeon performing prone versus lateral single-position LLIF, inclusive of the L4-L5 level.
METHODS: A retrospective review was performed of a consecutive case series of patients who underwent either prone or lateral, single-position LLIF by a single surgeon. All cases involved the L4-L5 level. Demographic data, perioperative details, clinical outcomes, and preoperative and postoperative lumbar lordosis were recorded.
RESULTS: Sixty-three patients underwent lateral and 16 patients underwent prone single-position LLIF. Demographics and average interbody size were similar between groups. Operative time, change in lumbar lordosis, and length of hospital stay did not differ between the 2 positions. Both groups performed similarly in terms of preoperative and postoperative visual analog score pain score and complications. Patients who underwent lateral position LLIF ambulated farther on postoperative day 1 (250 feet vs. 200 feet, P = 0.015). Average time to follow up was 53 weeks.
CONCLUSIONS: This study demonstrates promising preliminary results indicating that single-position LLIF performs well, even at the L4-L5 level, in both the prone and lateral positions.
Volume
187
First Page
460
Last Page
460
ISSN
1878-8769
Published In/Presented At
Sadhwani, S., Brown, M., Dalton, J., Nivar, I., Henzes, J., Marcinko, M., & Maugle, T. (2024). Single Position Lateral versus Prone Transpsoas Lateral Interbody Fusion Inclusive of L4-L5: A Single Surgeon Experience Examining Early Postoperative Outcomes. World neurosurgery, 187, e460–e464. https://doi.org/10.1016/j.wneu.2024.04.109
Disciplines
Medicine and Health Sciences
PubMedID
38663733
Department(s)
Fellows and Residents
Document Type
Article