Related Experiment Video
Updated: May 17, 2026
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Postoperative lumbar plexus injury after lumbar retroperitoneal transpsoas minimally invasive lateral interbody
Tien V Le1, Clinton J Burkett, Armen R Deukmedjian
1Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, FL 33606, USA. tienvle77@gmail.com
Study Design:
Retrospective review.
Objective:
To evaluate the motor and sensory deficit rate after the lumbar retroperitoneal transpsoas minimally invasive lateral interbody fusion (MIS LIF) by reviewing a single surgeon's experience.
Summary Of Background Data:
The MIS LIF is an increasingly used alternative to traditional open anterior or posterior operations to treat a host of spinal disorders. It has many advantages, but the potential for immediate postoperative thigh numbness, pain, and potential motor weakness has been reported. Published rates range widely in part because previous studies have based patient outcomes on data from different surgeons using different techniques.
Methods:
An institutional review board-approved, retrospective review of a prospectively collected database was conducted. Seventy-one consecutive patients who underwent this procedure between L1 and L5 during a 3-year period met criteria and were included. Postoperative clinical examinations immediately after surgery and during routine follow-up intervals were examined.
Results:
There was a 19.1% (14/71) rate of immediate postoperative ipsilateral thigh numbness during the study period. The annual rates of numbness progressively decreased annually. There was a 26.1% (6/23), 25% (5/20), and 10.7% (3/28) rate for 2008, 2009, and 2010, respectively. All patients with numbness had a fusion construct that involved L4-L5. More than half the patients, 54.9% (39/71), had immediate postoperative ipsilateral iliopsoas or quadriceps weakness. Of these, the vast majority had resolution by 3 months (92.3%), and all had complete resolution by 2 years.
Conclusion:
The lumbar retroperitoneal transpsoas MIS LIF is a safe alternative to traditional open operations for many spinal conditions. As with most minimally invasive techniques, there is a learning curve to be overcome to minimize the risk of iatrogenic nerve injuries. Our refined technique of the MIS LIF during a 3-year period has led to a significant reduction of the incidence of postoperative numbness of nearly 60% (from 26.1%-10.7%).
Insights
Minimally invasive lateral interbody fusion (MIS LIF) is a safe spinal surgery alternative. With technique refinement, the rate of postoperative thigh numbness decreased by nearly 60% over three years.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Minimally invasive lateral interbody fusion (MIS LIF) is an alternative to open spine surgery.
- Potential risks include thigh numbness and motor weakness.
- Previous studies reported varied complication rates due to differing techniques and surgeon experience.
Purpose of the Study:
- To evaluate motor and sensory deficit rates after lumbar retroperitoneal transpsoas MIS LIF.
- To assess outcomes based on a single surgeon's experience.
Main Methods:
- Retrospective review of a prospectively collected database.
- Included 71 consecutive patients undergoing MIS LIF between L1 and L5.
- Analyzed postoperative clinical examinations immediately after surgery and at follow-up intervals.
Main Results:
- 19.1% of patients experienced immediate postoperative ipsilateral thigh numbness.
- Numbness rates decreased annually, from 26.1% to 10.7% over three years.
- 54.9% had temporary iliopsoas or quadriceps weakness, with 92.3% resolving by 3 months.
Conclusions:
- Lumbar retroperitoneal transpsoas MIS LIF is a safe option for spinal conditions.
- A learning curve exists for minimizing iatrogenic nerve injuries.
- Refined MIS LIF techniques significantly reduced postoperative numbness incidence.
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