Prone-transpsoas as single-position, circumferential access to the lumbar spine: A brief survey of index cases

Stone, Lauren E; Wali, Arvin R.; Santiago-Dieppa, David R; Taylor, William R.

doi:10.1016/j.xnsj.2021.100053

Cited by 13 publications

(9 citation statements)

References 6 publications

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“…In this study, we found a mean operative duration of 226.2 minutes, which is even less than that reported by Soliman et al 15 The EBL in this study was 138.4 mL, which is within the range of blood loss for the standard LLIF reported in the literature (19-240 mL). 12,[23][24][25][26] In this study, a single case of vascular injury occurred during the ALIF procedure at the adjacent level and was not attributed to the PTP procedure. Aguirre et al 27 conducted a systematic review of vascular injury rates after standard LLIF, finding that it ranged between 0% and 2.6%.…”

Section: Length Of Stay and Intraoperative Datamentioning

confidence: 70%

Complications of the Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: A Multicenter Study

et al. 2023

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BACKGROUND AND OBJECTIVES: The prone transpsoas (PTP) approach for lateral lumbar interbody fusion (LLIF) is a novel technique for degenerative lumbar spine disease. However, there is a paucity of information in the literature on the complications of this procedure, with all published data consisting of small samples. We aimed to report the intraoperative and postoperative complications of PTP in the largest study to date. METHODS: A retrospective electronic medical record review was conducted at 11 centers to identify consecutive patients who underwent LLIF through the PTP approach between January 1, 2021, and December 31, 2021. The following data were collected: intraoperative characteristics (operative time, estimated blood loss [EBL], intraoperative complications [anterior longitudinal ligament (ALL) rupture, cage subsidence, vascular and visceral injuries]), postoperative complications, and hospital stay. RESULTS: A total of 365 patients were included in the study. Among these patients, 2.2% had ALL rupture, 0.3% had cage subsidence, 0.3% had a vascular injury, 0.3% had a ureteric injury, and no other visceral injuries were reported. Mean operative time was 226.2 ± 147.9 minutes. Mean EBL was 138.4 ± 215.6 mL. Mean hospital stay was 2.7 ± 2.2 days. Postoperative complications included new sensory symptoms—8.2%, new lower extremity weakness—5.8%, wound infection—1.4%, cage subsidence—0.8%, psoas hematoma—0.5%, small bowel obstruction and ischemia—0.3%, and 90-day readmission—1.9%. CONCLUSION: In this multicenter case series, the PTP approach was well tolerated and associated with a satisfactory safety profile.

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Section: Length Of Stay and Intraoperative Datamentioning

confidence: 70%

Complications of the Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: A Multicenter Study

et al. 2023

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“…Single-position lateral fusion approaches in the lateral decubitus position have been performed and studied, with some reports documenting a nearly 1-hour decrease in the mean operative time compared with two-stage procedures without compromising spinopelvic parameters. [10][11][12] However, this approach is associated with a higher rate of facet joint violation, leading to unnecessary repeat reoperation. 13 The PTP technique addresses certain drawbacks associated with both staged and lateral decubitus LLIF techniques.…”

Section: Discussionmentioning

confidence: 99%

Radiographic alignment outcomes after the single-position prone transpsoas approach: a multi-institutional retrospective review of 363 cases

Diaz-Aguilar

Stone

Soliman

et al. 2023

Neurosurgical Focus

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OBJECTIVE The aim of this paper was to evaluate the changes in radiographic spinopelvic parameters in a large cohort of patients undergoing the prone transpsoas approach to the lumbar spine. METHODS A multicenter retrospective observational cohort study was performed for all patients who underwent lateral lumber interbody fusion via the single-position prone transpsoas (PTP) approach. Spinopelvic parameters from preoperative and first upright postoperative radiographs were collected, including lumbar lordosis (LL), pelvic incidence (PI), and pelvic tilt (PT). Functional indices (visual analog scale score), and patient-reported outcomes (Oswestry Disability Index) were also recorded from pre- and postoperative appointments. RESULTS Of the 363 patients who successfully underwent the procedure, LL after fusion was 50.0° compared with 45.6° preoperatively (p < 0.001). The pelvic incidence–lumbar lordosis mismatch (PI-LL) was 10.5° preoperatively versus 2.9° postoperatively (p < 0.001). PT did not significantly change (0.2° ± 10.7°, p > 0.05). CONCLUSIONS The PTP approach allows significant gain in lordotic augmentation, which was associated with good functional results at follow-up.

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“…This falls within the range of 19 to 240 mL of blood loss for these procedures reported in the literature. 9,[22][23][24]26…”

Section: Blood Lossmentioning

confidence: 99%

Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: Case Series With an Operative Video Using Fluoroscopy-Based Instrument Tracking Guidance

Soliman

Ruggiero

Kuo

et al. 2022

Operative Neurosurgery

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BACKGROUND:Lateral lumbar interbody fusion has inherent limitations, such as the necessity to reposition the patient. To overcome this limitation, the prone transpsoas (PTP) approach for lateral lumbar interbody fusion has been developed.OBJECTIVE:To report clinical and radiographic outcome measures of a series of patients who underwent PTP at our hospital.METHODS:A retrospective chart review was conducted to identify patients who underwent PTP for degenerative lumbar spine disease between September 2019 and August 2021. A thorough analysis of clinical and radiographic outcome measures for these patients was conducted.RESULTS:Our search resulted in the identification of 15 consecutive patients. Four patients were operated using the assistance of fluoroscopy-based instrument tracking. Overall, the mean follow-up duration was 11.9 ± 7.9 months. Radiographically, the PTP approach resulted in significant postoperative improvement of lumbar lordosis (P = .03) and pelvic incidence minus lumbar lordosis (P < .005). No significant difference was found postoperatively in other regional sagittal alignment parameters, including pelvic tilt, sacral slope, or pelvic incidence. Clinically, the patients' Oswestry Disability Indices (P = .002) and Short Form Survey-12 Physical Scores improved significantly (P = .01). The estimated mean blood loss for patients who underwent the PTP procedure was 137.7 ± 96.4 mL, the mean operative time was 212.5 ± 77.1 minutes, and the mean hospital stay was 2.7 ± 1.4 days. One patient each had superficial wound infection, transient paralytic ileus, transient pulmonary embolism, transient urinary retention, or required revision lumbar surgery.CONCLUSION:This study demonstrates that the PTP approach is associated with significant improvement in radiographic and clinical outcomes.

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Prone-transpsoas as single-position, circumferential access to the lumbar spine: A brief survey of index cases

Cited by 13 publications

References 6 publications

Complications of the Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: A Multicenter Study

Complications of the Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: A Multicenter Study

Radiographic alignment outcomes after the single-position prone transpsoas approach: a multi-institutional retrospective review of 363 cases

Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: Case Series With an Operative Video Using Fluoroscopy-Based Instrument Tracking Guidance

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