The prone transpsoas technique: preliminary radiographic results of a multicenter experience

Pimenta, Luiz; Amaral, Rodrigo; Taylor, William R.; Tohmeh, Antoine; Pokorny, Gabriel; Rodrigues, Raquel; Arnoni, Daniel; Guirelli, Thyago; Batista, Matheus

doi:10.1007/s00586-020-06471-y

Cited by 37 publications

(49 citation statements)

References 27 publications

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“…In isolated cases of complex deformity, prone positioning enabled both right-and left-sided lateral approaches to optimize correction of double coronal curves. Sagittal corrections were also optimized, as it has been the authors' experience that prone positioning provides a significant improvement in positional lordosis, facilitating disc preparation and the use of 15 and even 20 degree lordotic cages without ALL release [16,17].…”

Section: Ptp Initial Multi-center Clinical Experiencementioning

confidence: 99%

Initial multi-centre clinical experience with prone transpsoas lateral interbody fusion: Feasibility, perioperative outcomes, and lessons learned

Smith¹,

Joseph²,

Ditty³

et al. 2021

North American Spine Society Journal (NASSJ)

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Section: Ptp Initial Multi-center Clinical Experiencementioning

confidence: 99%

Initial multi-centre clinical experience with prone transpsoas lateral interbody fusion: Feasibility, perioperative outcomes, and lessons learned

Smith¹,

Joseph²,

Ditty³

et al. 2021

North American Spine Society Journal (NASSJ)

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“…14 Initial results of the PTP technique have demonstrated improved clinical and radiographic outcomes. [15][16][17][18] In addition to the possible advantage of avoiding an intraoperative position change, proponents of the PTP technique have cited potential additional benefits such as improved intradiscal lordosis, facilitation of navigation setup, and more secure patient positioning when compared to traditional lateral decubitus LLIF. 18 Last, it has been purported that the lumbar plexus, traversing the intervertebral disc spaces within the psoas muscle, may be more posteriorly located during PTP compared to traditional lateral decubitus LLIF, which may increase the safe zone for access to the lumbar disc space, particularly at L4-L5.…”

Section: Introductionmentioning

confidence: 99%

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

Alluri

Clark

Sheha

et al. 2021

Global Spine Journal

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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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“…These specific complications were not reported in other studies involving the PTP procedures. 9,23,24…”

Section: Discussionmentioning

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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The prone transpsoas technique: preliminary radiographic results of a multicenter experience

Cited by 37 publications

References 27 publications

Initial multi-centre clinical experience with prone transpsoas lateral interbody fusion: Feasibility, perioperative outcomes, and lessons learned

Initial multi-centre clinical experience with prone transpsoas lateral interbody fusion: Feasibility, perioperative outcomes, and lessons learned

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

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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