{Reference Type}: Journal Article
{Title}: Single Position Lateral versus Prone Transpsoas Lateral Interbody Fusion Inclusive of L4-L5: A Single Surgeon Experience Examining Early Postoperative Outcomes.
{Author}: Sadhwani S;Brown M;Dalton J;Nivar I;Henzes J;Marcinko M;Maugle T;
{Journal}: World Neurosurg
{Volume}: 187
{Issue}: 0
{Year}: 2024 Jul 23
{Factor}: 2.21
{DOI}: 10.1016/j.wneu.2024.04.109
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.