Purpose: 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 stud 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 pre- and postoperative lumbar lordosis were recorded.
Results: 63 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 two positions. Both groups performed similarly in terms of pre- and postoperative VAS pain score, and complications. Patients who underwent lateral position LLIF ambulated farther on postoperative day 1 (250 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.
Keywords: Fusion; Interbody; Lateral; Prone; Transpsoas.
Copyright © 2024. Published by Elsevier Inc.