Abstract：
BACKGROUND: Lateral lumbar interbody fusion (LLIF) with posterior screw fusion is a safe and effective treatment for patients suffering from degenerative spine disorders. While LLIF has been shown to restore disc height, decompress neural components, correct sagittal imbalances, and improve pain scores, the approach requires repositioning patients for posterior pedicle fixation, which requires 2 separate surgeries. The evolution of surgical techniques, navigation, and robotics has allowed for a single position approach to LLIF with the patient in the prone position. The purpose of this study was to perform a systematic review and meta-analysis comparing the prone single position (PSP) LLIF approach to the dual position LLIF approach. We hypothesized that PSP LLIF will have a reduced operative time, complication rate, and blood loss compared with the dual position LLIF procedure.
METHODS: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed and Embase databases were searched with key terms: (lateral AND [interbody OR \"inter body\"] AND lumbar AND fusion) AND (prone OR single). Results were extracted and reviewed by 2 authors (MR and RB) per selection criteria. Patient demographics were extracted from the selected studies, along with surgical, patient-reported, and radiographic outcomes. A meta-analysis was performed using an unstandardized mean difference or log odds ratio with a confidence level of 95%.
RESULTS: Fifteen studies were included in the systematic review and 5 studies compared PSP LLIF to dual position LLIF for meta-analysis. PSP LLIF had a reduced operative time and length of stay compared with the dual position approach, although there was no significant reduction in estimated blood loss. Additionally, PSP LLIF improved lumbar lordosis more effectively than dual position LLIF. There was no difference in segmental lordosis or pelvic tilt. There was no difference in intraoperative complications, postoperative complications, or reoperations.
CONCLUSIONS: PSP LLIF reduces operative time and length of stay, with no relative increase in complications or reoperations compared with the dual position approach. Additionally, PSP LLIF improves lumbar lordosis relative to dual position LLIF, which may improve functional outcomes and reduce the risk of developing adjacent segment disease.
CONCLUSIONS: The associated operative and postoperative benefits of PSP LLIF may improve long-term outcomes of patients undergoing spinal fusion.
METHODS:
METHODS: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed and Embase databases were searched with key terms: (lateral AND [interbody OR \"inter body\"] AND lumbar AND fusion) AND (prone OR single). Results were extracted and reviewed by 2 authors (MR and RB) per selection criteria. Patient demographics were extracted from the selected studies, along with surgical, patient-reported, and radiographic outcomes. A meta-analysis was performed using an unstandardized mean difference or log odds ratio with a confidence level of 95%.
RESULTS: Fifteen studies were included in the systematic review and 5 studies compared PSP LLIF to dual position LLIF for meta-analysis. PSP LLIF had a reduced operative time and length of stay compared with the dual position approach, although there was no significant reduction in estimated blood loss. Additionally, PSP LLIF improved lumbar lordosis more effectively than dual position LLIF. There was no difference in segmental lordosis or pelvic tilt. There was no difference in intraoperative complications, postoperative complications, or reoperations.
CONCLUSIONS: PSP LLIF reduces operative time and length of stay, with no relative increase in complications or reoperations compared with the dual position approach. Additionally, PSP LLIF improves lumbar lordosis relative to dual position LLIF, which may improve functional outcomes and reduce the risk of developing adjacent segment disease.
CONCLUSIONS: The associated operative and postoperative benefits of PSP LLIF may improve long-term outcomes of patients undergoing spinal fusion.
METHODS:
摘要：
背景：外侧腰椎椎间融合术（LLIF）与后路螺钉融合术对于患有退行性脊柱疾病的患者是一种安全有效的治疗方法。虽然LLIF已被证明可以恢复光盘高度，解压缩神经成分，纠正矢状不平衡,改善疼痛评分，该方法需要重新定位患者进行后路椎弓根固定，这需要两个单独的手术。外科技术的发展，导航,并且机器人技术允许在患者处于俯卧位的情况下对LLIF进行单位置方法。这项研究的目的是进行系统评价和荟萃分析，比较俯卧单位置（PSP）LLIF方法与双位置LLIF方法。我们假设PSPLLIF将减少手术时间，并发症发生率,与双位置LLIF程序相比，失血量。
方法：根据2020年系统评价和荟萃分析指南的首选报告项目进行系统评价。使用关键术语搜索PubMed和Embase数据库：（横向和[体间或“体间”]和腰椎和融合）和（俯卧或单）。根据选择标准，由2位作者（MR和RB）提取和审查结果。从选定的研究中提取患者的人口统计数据，随着外科手术，患者报告，和射线照相结果。使用非标准化平均差或对数比值比进行荟萃分析，置信水平为95％。
结果：15项研究纳入系统评价，5项研究比较了PSPLLIF与双位置LLIF的荟萃分析。与双位置入路相比，PSPLLIF减少了手术时间和住院时间。尽管估计的失血量没有显着减少。此外,PSPLLIF比双位置LLIF更有效地改善腰椎前凸。节段前凸或骨盆倾斜没有差异。术中并发症无差异，术后并发症,或重新操作。
结论：PSPLLIF可缩短手术时间和住院时间，与双体位入路相比，并发症或再手术没有相对增加。此外,PSPLLIF相对于双位置LLIF可改善腰椎前凸,这可能会改善功能结局并降低发生相邻节段疾病的风险。
结论：PSPLLIF的相关手术和术后益处可能会改善脊柱融合术患者的长期预后。
方法：
方法：根据2020年系统评价和荟萃分析指南的首选报告项目进行系统评价。使用关键术语搜索PubMed和Embase数据库：（横向和[体间或“体间”]和腰椎和融合）和（俯卧或单）。根据选择标准，由2位作者（MR和RB）提取和审查结果。从选定的研究中提取患者的人口统计数据，随着外科手术，患者报告，和射线照相结果。使用非标准化平均差或对数比值比进行荟萃分析，置信水平为95％。
结果：15项研究纳入系统评价，5项研究比较了PSPLLIF与双位置LLIF的荟萃分析。与双位置入路相比，PSPLLIF减少了手术时间和住院时间。尽管估计的失血量没有显着减少。此外,PSPLLIF比双位置LLIF更有效地改善腰椎前凸。节段前凸或骨盆倾斜没有差异。术中并发症无差异，术后并发症,或重新操作。
结论：PSPLLIF可缩短手术时间和住院时间，与双体位入路相比，并发症或再手术没有相对增加。此外,PSPLLIF相对于双位置LLIF可改善腰椎前凸,这可能会改善功能结局并降低发生相邻节段疾病的风险。
结论：PSPLLIF的相关手术和术后益处可能会改善脊柱融合术患者的长期预后。
方法：
