Single-position surgery versus lateral-then-prone-position circumferential lumbar interbody fusion: a systematic literature review

Abstract Lateral lumbar interbody fusion (LLIF) is a widely used technique for anterior fusion. However, posterior decompression or instrumentation often requires repositioning the patient, which increases operative time. This video describes the prone LLIF as a modification of the standard surgical technique. The prone LLIF facilitates simultaneous decompression and fusion, which avoids the need for repositioning the patient, increasing operative efficiency. Positioning, fluoroscopic considerations, and operative nuances involved in performing the LLIF in the prone position are described, and an illustrative case is presented. The patient provided informed consent for the procedure and videography. LLIF in the prone position can decrease operative time and increase operative efficiency. The prone position is a viable alternative to the conventional lateral decubitus position. Video used with permission from Barrow Neurological Institute, Phoenix, Arizona.

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Minimally invasive transforaminal lumbar interbody fusion with percutaneous bilateral pedicle screw fixation for lumbosacral spine degenerative diseases. a retrospective database of 40 consecutive treated cases and literature review.

Turkish Neurosurgery ◽

10.5137/1019-5149.jtn.19479-16.0 ◽

2017 ◽

Cited By ~ 4

Author(s):

Daniele Francesco Millimaggi ◽

Valerio Di Norcia ◽

Sabino Luzzi ◽

Tommaso Alfiero ◽

Renato Juan Galzio ◽

...

Keyword(s):

Literature Review ◽

Interbody Fusion ◽

Screw Fixation ◽

Transforaminal Lumbar Interbody Fusion ◽

Pedicle Screw Fixation ◽

Lumbosacral Spine ◽

Lumbar Interbody Fusion ◽

Degenerative Diseases ◽

Bilateral Pedicle Screw ◽

Retrospective Database

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Posterior Revision of Lumbar Interbody Fusion Cages Migration: Clinical Case Series and Literature Review

Egyptian Spine Journal ◽

10.21608/esj.2017.6754 ◽

2017 ◽

Vol 23 (1) ◽

pp. 13-22

Author(s):

Ayman Galhom ◽

Ahmed Elsawaf ◽

Mohamed Khattab

Keyword(s):

Literature Review ◽

Clinical Case ◽

Interbody Fusion ◽

Case Series ◽

Lumbar Interbody Fusion

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Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position

Global Spine Journal ◽

10.1177/21925682211049170 ◽

2021 ◽

pp. 219256822110491

Author(s):

Ram Alluri ◽

Nicholas Clark ◽

Evan Sheha ◽

Karim Shafi ◽

Matthew Geiselmann ◽

...

Keyword(s):

Prone Position ◽

Interbody Fusion ◽

Femoral Nerve ◽

Psoas Muscle ◽

Lateral Decubitus Position ◽

Lumbar Plexus ◽

Lumbar Interbody Fusion ◽

Posterior Edge ◽

Disc Space ◽

Lateral Decubitus

Study Design Cadaveric study. Objective To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position. Methods Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and marked with radiopaque paint. Lateral fluoroscopic images of the cadaveric specimens in the lateral decubitus vs prone position were obtained. The location of the radiopaque femoral nerve at the L4-L5 disc space was normalized as a percentage of the L5 vertebral body (0% indicates posterior location and 100% indicates anterior location at the L4-L5 disc space). The location of the femoral nerve at L4-L5 in the lateral decubitus vs prone position was compared using a paired t test. Results In the lateral decubitus position, the femoral nerve was located 28% anteriorly from the posterior edge of the L4-L5 disc space, and in the prone position, the femoral nerve was relatively more posterior, located 18% from the posterior edge of the L4-L5 disc space ( P = .037). Conclusions The femoral nerve was on average more posteriorly located at the L4-L5 disc space in the prone position compared to lateral decubitus. This more posterior location allows for a larger safe zone at the L4-L5 disc space, which may decrease the incidence of neurologic complications associated with Lateral lumbar interbody fusion in the prone vs lateral decubitus position; however, further studies are needed to evaluate this possible clinical correlation.

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