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Single Position Lateral versus Prone Transpsoas Lateral Interbody Fusion Inclusive of L4-L5: A single surgeon experience examining early post-operative outcomes – Lumbar Spinal Stenosis

The article discusses the comparison between prone and lateral single-position lumbar interbody fusion (LLIF) procedures, focusing on the L4-L5 level. The study aimed to evaluate outcomes such as operative time, change in lumbar lordosis, hospital stay, VAS pain score, ambulation on postoperative day 1, and complications between the two positions. The results showed that both prone and lateral single-position LLIF performed similarly in terms of clinical outcomes and complications. However, patients who underwent the lateral position LLIF were able to ambulate further on postoperative day 1. Overall, the study suggests that single-position LLIF is effective and feasible, even at the L4-L5 level, in both prone and lateral positions

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

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.

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World Neurosurg. 2024 Apr 23:S1878-8750(24)00682-X. doi: 10.1016/j.wneu.2024.04.109. Online ahead of print. ABSTRACT 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,

World Neurosurg. 2024 Apr 23:S1878-8750(24)00682-X. doi: 10.1016/j.wneu.2024.04.109. Online ahead of print.

ABSTRACT

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.

PMID:38663733 | DOI:10.1016/j.wneu.2024.04.109

The London Spine Unit : the highest rated spinal centre in London

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Single Position Lateral versus Prone Transpsoas Lateral Interbody Fusion Inclusive of L4-L5: A single surgeon experience examining early post-operative outcomes

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World Neurosurg. 2024 Apr 23:S1878-8750(24)00682-X. doi: 10.1016/j.wneu.2024.04.109. Online ahead of print. ABSTRACT 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
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