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Related Concept Videos

Anatomical Positions01:11

Anatomical Positions

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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
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Related Experiment Video

Updated: Jan 15, 2026

Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
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Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique

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Table Rotation Technique to Access the L4-5 Disc Space in the Prone Transpsoas Approach: A Technical Note.

Bryan S Lee1, Michael D White1, Rodrigo Amaral2

  • 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.

Global Spine Journal
|January 13, 2026
PubMed
Summary
This summary is machine-generated.

A novel table rotation technique improved electromyography (EMG) safety during prone transpsoas (PTP) lumbar fusion surgery. This method reduced the risk of nerve injury by moving the surgical corridor away from the lumbar plexus.

Keywords:
LLIFfemoral nervelateral interbody fusionlumbar plexusneuropraxiaprone transpsoasprone transpsoas approachtable rotation

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Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
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Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Orthopedic Surgery

Background:

  • Prone transpsoas (PTP) lateral lumbar interbody fusion is a surgical technique used for lumbar spine pathologies.
  • Safe placement of surgical instruments during PTP surgery is crucial to avoid neurological injury.
  • Electromyography (EMG) monitoring is used to assess nerve proximity during spinal procedures.

Purpose of the Study:

  • To compare EMG recordings using a novel table rotation technique versus the standard technique for PTP lumbar fusion.
  • To evaluate the safety and efficacy of the table rotation technique in reducing the risk of lumbar plexus injury.

Main Methods:

  • Retrospective analysis and case series of 10 patients undergoing single-level PTP surgery at L4-5.
  • EMG recordings were taken at anterior and posterior locations with the operating table in neutral and rotated (30°) positions.
  • Comparison of EMG values between the two table positions to assess safety thresholds.

Main Results:

  • All patients demonstrated significantly improved EMG values after table rotation.
  • Before rotation, 70% of patients had posterior EMG values in the risk zone (>6 mA) at the psoas and 50% at the disc space.
  • After rotation, no patients exhibited posterior EMG recordings in the risk zone, indicating enhanced safety.

Conclusions:

  • The table rotation technique provides a safer corridor for accessing the L4-5 disc space during PTP surgery.
  • This technique effectively moves the surgical trajectory away from the lumbar plexus, achieving safer EMG thresholds.
  • The novel technique enhances patient safety during prone transpsoas lumbar fusion procedures.