Prone Lateral Lumbar Interbody Fusion: Case Report and Technical Note

Authors

Nikolay L. Martirosyan, Department of Neurosurgery, Allen Memorial Hospital, UnityPoint Clinic, Waterloo, Iowa, USA. Electronic address: Nikolay.Martirosyan@unitypoint.org.Follow
Juan S. Uribe, Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Blake M. Randolph, Department of Neurosurgery, Allen Memorial Hospital, UnityPoint Clinic, Waterloo, Iowa, USA.
Russell I. Buchanan, Department of Neurosurgery, Allen Memorial Hospital, UnityPoint Clinic, Waterloo, Iowa, USA.

Document Type

Article

Abstract

OBJECTIVE: The transpsoas lateral lumbar interbody fusion (LLIF) is a commonly used technique to manage various spinal conditions. LLIF is often performed in combination with posterior lumbar instrumentation, which requires patient repositioning or staging of the procedure. Here we present a step-by-step detailed description of a prone LLIF using an intraoperative laser level to guide orthogonal insertion of instrumentation. METHODS: A 57-year-old man with history of L4-S1 instrumentation, who developed symptomatic adjacent L3L/4 level stenosis and sagittal plane imbalance. The single position prone lateral lumbar interbody fusion with posterior fixation was chosen in order to minimize operative room time and optimize lumbar lordosis (LL) correction. RESULTS: The patient was positioned prone on a Jackson table. This position allowed for improved LL correction. A self-leveling laser line ensured ideal orthogonal use of instrumentation. The patient had improvement of symptoms immediately postoperatively and was discharged home on postoperative day 2 without complications. CONCLUSIONS: The single position prone LLIF with posterior fixation offers a shorter operative room time by eliminating necessity to reposition the patient between stages of operation. The prone position of the patient optimizes LL correction. Further experience with this approach will allow for refining of the technique to overcome its limitations and facilitate its utilization.

Medical Subject Headings

Humans; Internal Fixators; Lasers; Lordosis (surgery); Lumbar Vertebrae (surgery); Male; Middle Aged; Operative Time; Patient Positioning (methods); Prone Position; Spinal Fusion (methods); Spinal Stenosis (surgery); Tomography, X-Ray Computed; Treatment Outcome

Publication Date

12-1-2020

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

144

First Page

170

Last Page

177

PubMed ID

32896618

Digital Object Identifier (DOI)

10.1016/j.wneu.2020.08.172

Recommended Citation

Martirosyan, Nikolay L.; Uribe, Juan S.; Randolph, Blake M.; and Buchanan, Russell I., "Prone Lateral Lumbar Interbody Fusion: Case Report and Technical Note" (2020). Neurosurgery. 1715.
https://scholar.barrowneuro.org/neurosurgery/1715