Related Experiment Video
Updated: May 27, 2026
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Neurologic deficit following lateral lumbar interbody fusion
Matthias Pumberger1, Alexander P Hughes, Russel R Huang
1Department of Orthopedic Surgery, Spine and Scoliosis Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
Insights
Lateral lumbar interbody fusion (LLIF) is a minimally invasive spinal surgery. This study found LLIF has a low incidence of neurological deficits, with surgery duration being a key risk factor.
Area of Science:
- Neurosurgery
- Spinal Fusion Techniques
- Minimally Invasive Surgery
Background:
- Lateral lumbar interbody fusion (LLIF) is an increasingly utilized minimally invasive surgical technique for spinal fusion.
- Understanding the incidence and characteristics of neurological deficits is crucial for patient safety and surgical planning.
Purpose of the Study:
- To determine the incidence and nature of neurological deficits following LLIF.
- To identify potential risk factors associated with these deficits.
Main Methods:
- Retrospective review of medical records and operative reports for patients undergoing LLIF between March 2006 and December 2009.
- Systematic recording of new sensory and motor deficits at multiple follow-up intervals (6 and 12 weeks, 6 and 12 months).
- Correlation of neurological events with patient demographics, pre-operative diagnosis, operative levels, and surgical duration.
Main Results:
- A total of 235 patients with 444 fused levels were analyzed.
- At 12 months post-surgery, prevalence rates were: sensory deficits (1.6%), psoas mechanical deficits (1.6%), and lumbar plexus related deficits (2.9%).
- Surgical duration was identified as an independent risk factor for both psoas mechanical hip flexion and lumbar plexus related motor deficits.
Conclusions:
- LLIF is an effective minimally invasive approach for lumbar interbody fusion.
- The technique demonstrates a low risk of neurovascular complications.
- Prolonged surgical duration is associated with an increased risk of specific motor deficits.
Purpose:
Lateral lumbar interbody fusion (LLIF) is a minimally invasive technique that has gained growing interest in recent years. We performed a retrospective review of the medical records and operative reports of patients undergoing LLIF between March 2006 and December 2009. We seek to identify the incidence and nature of neurological deficits following LLIF.
Methods:
New occurring sensory and motor deficits were recorded at 6 and 12 weeks as well as 6- and 12 months of follow-up. Motor deficits were grouped according to the muscle weakness and severity and sensory deficits to the dermatomal zone. New events were correlated to the patient demographics, pre-operative diagnosis, operative levels, and duration of surgery. At each post-operative time-point patients were queried regarding the presence of leg pain.
Results:
A total of 235 patients (139 F; 96 M) with a total of 444 levels fused were included. Average age was 61.5 and mean BMI 28.3. At 12 months' follow-up, the prevalence of sensory deficits was 1.6%, psoas mechanical deficit was 1.6% and lumbar plexus related deficits 2.9%. Although there was no significant correlation between the surgical level L4-5 and an increased psoas mechanical flexion or lumbar plexus related motor deficit, a trend was observed. Independent risk factors for both psoas mechanical hip flexion deficit and lumbar plexus related motor deficit was duration of surgery.
Conclusion:
LLIF is a valuable tool for achieving fusion through a minimally invasive approach with little risk to neurovascular structures.
