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

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.
• 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.