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Updated: Feb 12, 2026
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Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
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Posicionamiento óptimo para la fusión intercuerpo lumbar lateral de posición única
Worawat Limthongkul1,2, Natavut Prasertkul1, Pakawas Praisarnti1
1Department of Orthopaedic Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Neurospine
|February 10, 2026
Resumen
La flexión de la cadera en la posición de decúbito lateral derecho altera significativamente la lordosis lumbar y la alineación pélvica. Una flexión de la cadera derecha de 30° con la cadera izquierda neutra imita mejor la alineación de pie para la cirugía espinal mínimamente invasiva.
Área de la Ciencia:
- Cirugía de la columna vertebral cirugía de la columna vertebral.
- La ortopedia es la ortopedia.
- El análisis biomecánico.
Sus antecedentes:
- La cirugía espinal mínimamente invasiva a menudo utiliza la posición de decúbito lateral derecho (RLDP).
- El mantenimiento de la alineación fisiológica lumbar y pélvica en RLDP es crucial para los resultados quirúrgicos.
- El efecto de las diferentes posiciones de la cadera en los parámetros spinopelvicos en el RLDP requiere cuantificación.
Objetivo del estudio:
- Para cuantificar el impacto de diferentes ángulos de flexión de la cadera en la lordosis lumbar (LL) y los parámetros spinopelvicos en el RLDP.
- Para determinar la configuración óptima de la cadera en RLDP que más estrechamente replica la alineación de pie.
- Para informar el posicionamiento quirúrgico para la fusión intercorporal lumbar lateral.
Principales métodos:
- Treinta voluntarios sanos se sometieron a radiografía lumbar lateral en posición de pie y cinco configuraciones RLDP.
- Se tomaron radiografías con diferentes flexiones de cadera: flexión bilateral neutral, 30° y 60°, y flexión unilateral de 30° y 60° (cadera derecha).
- Se midieron la lordosis lumbar, la inclinación pélvica, la pendiente sacra y la incidencia pélvica y se compararon con la alineación de pie.
Principales resultados:
- Todas las posiciones de RLDP demostraron una disminución significativa en LL en comparación con las permanentes.
- La flexión de la cadera derecha de 30° con la posición neutra de la cadera izquierda (30FN) mostró la desviación más pequeña en LL (-4,9°).
- La posición 30FN también resultó en una ligera rotación pélvica anterior, con disminución de la inclinación pélvica y aumento de la pendiente sacra.
Conclusiones:
- La posición de la cadera influye críticamente en la alineación lumbar y pélvica durante el RLDP.
- La configuración de cadera 30FN proporciona la aproximación más cercana a la alineación de pie y la armonía spinopelvica en RLDP.
- Este hallazgo es significativo para optimizar la posición del paciente durante los procedimientos de fusión intercuerpo lumbar lateral.
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