Supra-psoas shallow docking in lateral interbody fusion

Area of Science:

• Neurosurgery
• Spinal Fusion Techniques
• Minimally Invasive Spine Surgery

Background:

• Lateral interbody fusion (LIF) is associated with significant postoperative morbidity, primarily due to direct psoas muscle trauma.
• Neurological complications, including motor weakness/palsy and sensory dysesthesia, are common after LIF and can be permanent.
• These complications arise from nerve injury during passage through the psoas muscle.

Purpose of the Study:

• To detail the operative technique for lateral interbody fusion utilizing a supra-psoas retractor docking approach.
• To evaluate the safety and efficacy of this novel technique in minimizing neurological complications.

Main Methods:

• The study describes the supra-psoas shallow docking surgical technique, including patient positioning and side selection.
• Patient outcomes were assessed following the procedure.

Main Results:

• Fifteen patients underwent lateral interbody fusion using the supra-psoas shallow docking method.
• No patients reported postoperative motor weakness, sensory numbness, or pain on the surgical side.
• The technique appeared to minimize common neurological complications associated with lateral transpsoas interbody fusion.

Conclusions:

• The supra-psoas shallow docking technique offers a potentially safer alternative to traditional LIF by avoiding direct psoas muscle traversal.
• This method may decrease postoperative neurological morbidities by docking above the psoas muscle.
• Direct visualization of the lumbosacral plexus is a key benefit, potentially reducing neurological injury.