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Updated: Aug 26, 2025

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Ten-Step 3-Dimensional-Navigated Single-Stage Lateral Surgery With Microtubular Decompression: A Case Series.

Lynn B McGrath1, Pravesh S Gadjradj, Ibrahim Hussain

  • 1Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York, USA.

Operative Neurosurgery (Hagerstown, Md.)
|October 13, 2022
PubMed
Summary

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Single-stage lateral lumbar interbody fusion with added direct tubular decompression (SSLLIF+) is safe and effective. This technique improves outcomes for patients needing more than indirect decompression, avoiding further surgery.

Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spine Surgery

Background:

  • Single-stage lateral lumbar interbody fusion (LLIF) effectively treats lumbar pathologies via indirect decompression.
  • LLIF has a 9% failure rate in indirect decompression, potentially requiring revision surgery.
  • A modified technique, SSLLIF+, incorporates minimally invasive direct tubular decompression to address this limitation.

Purpose of the Study:

  • To detail the procedural steps of the novel SSLLIF+ technique.
  • To report on the clinical outcomes of patients undergoing SSLLIF+.
  • To establish SSLLIF+ as a viable alternative for complex lumbar decompression.

Main Methods:

  • Retrospective case series utilizing prospectively collected data.
  • Detailed description of the SSLLIF+ surgical approach.

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  • Analysis of surgical and clinical outcomes over a 5-year period at a single center.

    • Main Results:

    • SSLLIF+ was successfully performed in 7 patients, fusing 18 levels and decompressing 7.
    • No intraoperative complications occurred during the SSLLIF+ procedures.
    • One revision was needed for adjacent segment disease after 20 months; no delayed direct decompression was required.

    Conclusions:

    • SSLLIF+ with direct lateral tubular decompression is safe and effective when indirect decompression is insufficient.
    • Adherence to minimally invasive principles and careful patient selection are key to successful SSLLIF+ outcomes.
    • The SSLLIF+ technique offers a short hospital stay and low perioperative complication risk.