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Advancing Prone-Transpsoas Spine Surgery: A Narrative Review and Evolution of Indications with Representative Cases – Lumbar Fusion

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The article discusses the Prone Transpsoas (PTP) approach to lumbar spine surgery, which has emerged as an evolution of lateral lumbar interbody fusion (LLIF) and offers several advantages over traditional methods. PTP has shown increased lumbar lordosis gains compared to LLIF due to the natural increase in lordosis afforded by prone positioning. The prone position provides anatomical advantages, reducing the likelihood of postoperative femoral plexopathy and improving operative efficiency by eliminating the need for intraoperative position changes. PTP is versatile and can be used for various lumbar pathologies, with growing evidence suggesting it is at least as safe as traditional approaches with potentially better complication profiles. The article also discusses adjuncts of PTP, including robotics and radiation-reduction methods, and illustrates its versatility in addressing different types of lumbar surgeries

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Published article

The Prone Transpsoas (PTP) approach to lumbar spine surgery, emerging as an evolution of lateral lumbar interbody fusion (LLIF), offers significant advantages over traditional methods. PTP has demonstrated increased lumbar lordosis gains compared to LLIF, owing to the natural increase in lordosis afforded by prone positioning. Additionally, the prone position offers anatomical advantages, with shifts in the psoas muscle and lumbar plexus, reducing the likelihood of postoperative femoral…

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
J Clin Med. 2024 Feb 16;13(4):1112. doi: 10.3390/jcm13041112.ABSTRACTThe Prone Transpsoas (PTP) approach to lumbar spine surgery, emerging as an evolution of lateral lumbar interbody fusion (LLIF), offers significant advantages over traditional methods. PTP has demonstrated increased lumbar lordosis gains compared to LLIF, owing to the natural increase in lordosis afforded by prone positioning. Additionally, the,

J Clin Med. 2024 Feb 16;13(4):1112. doi: 10.3390/jcm13041112.

ABSTRACT

The Prone Transpsoas (PTP) approach to lumbar spine surgery, emerging as an evolution of lateral lumbar interbody fusion (LLIF), offers significant advantages over traditional methods. PTP has demonstrated increased lumbar lordosis gains compared to LLIF, owing to the natural increase in lordosis afforded by prone positioning. Additionally, the prone position offers anatomical advantages, with shifts in the psoas muscle and lumbar plexus, reducing the likelihood of postoperative femoral plexopathy and moving critical peritoneal contents away from the approach. Furthermore, operative efficiency is a notable benefit of PTP. By eliminating the need for intraoperative position changes, PTP reduces surgical time, which in turn decreases the risk of complications and operative costs. Finally, its versatility extends to various lumbar pathologies, including degeneration, adjacent segment disease, and deformities. The growing body of evidence indicates that PTP is at least as safe as traditional approaches, with a potentially better complication profile. In this narrative review, we review the historical evolution of lateral interbody fusion, culminating in the prone transpsoas approach. We also describe several adjuncts of PTP, including robotics and radiation-reduction methods. Finally, we illustrate the versatility of PTP and its uses, ranging from ‘simple’ degenerative cases to complex deformity surgeries.

PMID:38398424 | DOI:10.3390/jcm13041112

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Advancing Prone-Transpsoas Spine Surgery: A Narrative Review and Evolution of Indications with Representative Cases

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J Clin Med. 2024 Feb 16;13(4):1112. doi: 10.3390/jcm13041112.ABSTRACTThe Prone Transpsoas (PTP) approach to lumbar spine surgery, emerging as an evolution of lateral lumbar interbody fusion (LLIF), offers significant advantages over traditional methods. PTP has demonstrated increased lumbar lordosis gains compared to LLIF, owing to the natural increase in lordosis afforded by prone positioning. Additionally, the
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