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Single-position prone lateral approach: cadaveric feasibility study and early clinical experience
Jakub Godzik1, Ifije E Ohiorhenuan1, David S Xu2
11Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.
Neurosurgical Focus
|September 2, 2020
Summary
This study shows that performing lateral lumbar interbody fusion (LLIF) in a single prone position is feasible and safe. This approach simplifies lumbar spine surgery, potentially offering clinical and economic benefits.
Area of Science:
- Spinal Surgery
- Minimally Invasive Techniques
- Anatomy
Background:
- Lateral lumbar interbody fusion (LLIF) is a minimally invasive procedure for anterior interbody fusion and lumbar lordosis restoration.
- Achieving circumferential fusion after LLIF typically requires patient repositioning or lateral pedicle screw placement, adding complexity.
- This study investigates a novel single-position approach: LLIF performed in the prone lateral (PL) position.
Observation:
- A cadaveric feasibility study demonstrated successful PL LLIF without neurovascular or visceral injury.
- An early clinical series of 11 patients (89% success rate) undergoing PL LLIF showed no intraoperative subsidence.
- Mean retractor time per level was 15 ± 6 minutes, with variations based on lumbar level.
Findings:
- Single-position prone lateral LLIF is anatomically feasible.
- Early clinical data suggest the PL LLIF technique is safe and reproducible.
- No intraoperative subsidence was observed in the clinical cohort.
Implications:
- The prone lateral approach streamlines surgical access to the lumbar spine.
- This technique offers potential for more efficient surgical solutions.
- PL LLIF may provide significant clinical and economic advantages in spinal fusion procedures.
