Prone position lateral interbody fusion-a narrative review

Area of Science:

• Spine surgery
• Orthopedic surgery
• Minimally invasive spine procedures

Background:

• Lateral access lumbar interbody fusion provides anterior column support.
• Traditionally performed in the lateral decubitus position, often requiring patient repositioning for posterior fixation.
• Prone positioning for lateral lumbar interbody fusion is an emerging technique.

Purpose of the Study:

• To review the literature on lateral access lumbar interbody fusion performed in the prone position.
• To summarize the advantages, disadvantages, and unique aspects of this surgical approach.

Main Methods:

• A narrative review of PubMed-indexed articles published up to November 1, 2022.
• Search terms included "prone lateral spine surgery" and "lateral approach spine surgery" AND "prone position".
• Exclusion of non-English articles; independent review of abstracts and full-text articles.

Main Results:

• Advantages include simplified pedicle screw fixation, combined posterior and lateral access, and improved lordosis achievement.
• Potential benefits include safer positioning of neural and abdominal structures.
• Disadvantages involve challenges in surgical exposure, retraction, visualization, and ergonomics.

Conclusions:

• Prone lateral interbody fusion is a growing technique with distinct benefits and drawbacks compared to the lateral decubitus position.
• This approach may offer significant advantages for specific surgical indications and goals in lumbar interbody fusion.