Two-dimensional fluoroscopic instrument tracking-assisted prone lateral lumbar interbody fusion

A 55-year-old male with prior L5-S1 posterior lumbar interbody fusion developed adjacent segment degeneration with severe stenosis at L3-4 and L4-5 and underwent L3-5 prone lateral lumbar interbody fusion with extension of fusion using 2D fluoroscopic instrument tracking (2D-FIT). The TrackX system used standard anteroposterior and lateral fluoroscopic images to assist with trajectory planning, docking, retractor placement, disc preparation, trialing, and cage delivery. Simultaneous percutaneous pedicle screw fixation was performed by a co-surgeon to improve single-position efficiency. There were no intraoperative complications, neurological examinations remained stable, and hardware alignment was satisfactory. The patient was discharged home on postoperative day 3. Two-dimensional FIT helps improve efficiency without compromising safety. The video can be found here: https://stream.cadmore.media/r10.3171/2026.4.FOCVID2643.