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Updated: Oct 15, 2025
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Novel Mini-open Transforaminal Lumbar Interbody Fusion
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240
Single position lumbar fusion: a systematic review and meta-analysis
Emily S Mills1, Joshua Treloar1, Olumuyiwa Idowu1
1Keck School of Medicine, Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA.
Summary
Single position lumbar fusion surgery reduces operative time and hospital stay compared to traditional methods. Prone single position surgery involves longer operative and radiation times than lateral single position surgery.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Minimally invasive spine techniques
Background:
- Single position lumbar fusion combines anterior/lateral interbody fusion with posterior percutaneous pedicle screw fixation in one operative position.
- This technique aims to streamline surgical procedures for lumbar spine conditions.
Purpose of the Study:
- To systematically review and analyze the existing evidence on single position lumbar fusion.
- To compare the outcomes of single position (SP) surgery versus traditional dual position (flipped) surgery.
- To compare lateral single position (LSP) surgery versus prone single position (PSP) surgery.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Inclusion of prospective and retrospective studies in English on lumbar degenerative disease, spondylolisthesis, or radiculopathy.
- Meta-analyses compared SP vs. F groups and LSP vs. PSP groups, analyzing operative time, blood loss, hospital stay, radiation exposure, and radiographic outcomes.
Main Results:
- Single position (SP) surgery demonstrated significantly reduced operative time (127.5 min vs. 188.7 min) and hospital length of stay (2.87 days vs. 6.63 days) compared to flipped (F) surgery.
- Complication rates were similar between SP and F groups, though lateral pedicle screw placement had higher complication rates (10.2%) than prone (1.6%).
- Lateral single position (LSP) surgery showed significantly less operative time (117.1 min vs. 166.9 min) and X-ray exposure (43.7 min vs. 171.0 min) compared to prone single position (PSP) surgery, which resulted in greater postoperative segmental lordosis.
Conclusions:
- Single position lumbar fusion effectively decreases operative times and hospital length of stay.
- Complication rates and radiographic outcomes are comparable between single position and traditional multi-position techniques.
- Lateral single position surgery offers advantages over prone single position surgery in terms of reduced operative and radiation exposure, though prone positioning may enhance postoperative segmental lordosis.
