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

Luis Diaz-Aguilar, Department of Neurological Surgery, University of California, San Diego, La Jolla, California.
Lauren E. Stone, Department of Neurological Surgery, University of California, San Diego, La Jolla, California.
Mohamed A. Soliman, Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Alexander Padovano, Department of Orthopaedic Surgery, WakeMed, Raleigh, North Carolina.
Jeff Ehresman, Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.
Nolan J. Brown, Department of Neurological Surgery, University of Irvine, California.
Gautam Produturi, Department of Neurological Surgery, University of California, San Diego, La Jolla, California.
Madison Battista, Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.
Asham Khan, Department of Neurological Surgery, University at Buffalo, New York.
John Pollina, Department of Neurological Surgery, University at Buffalo, New York.
Rodrigo Amaral, Department of Neurological Surgery, Instituto de Patologia da Coluna, São Paulo Sul, Brazil.
Muhammad M. Abd-El-Barr, Department of Neurological Surgery, Duke University, Durham, North Carolina.
Isaac Moss, Department of Orthopedic Surgery, University of Connecticut, Farmington, Connecticut.
Tyler Smith, Spine Institute, Roseville, California.
Gurvinder S. Deol, Department of Orthopaedic Surgery, WakeMed, Raleigh, North Carolina.
Bryan S. Lee, Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.Follow
M Craig McMains, McMains Spine, Indianapolis, Indiana.
Samuel A. Joseph, Joseph Spine Institute, Tampa, Florida; and.
David Schwartz, OrthoIndy, Indianapolis, Indiana.
Luiz Pimenta, Department of Neurological Surgery, Instituto de Patologia da Coluna, São Paulo Sul, Brazil.
Andrew D. Nguyen, Department of Neurological Surgery, University of California, San Diego, La Jolla, California.
William R. Taylor, Department of Neurological Surgery, University of California, San Diego, La Jolla, California.

Document Type

Article

Abstract

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.

Medical Subject Headings

Humans; Retrospective Studies; Lordosis (diagnostic imaging, surgery); Postoperative Complications (epidemiology); Spinal Fusion (methods); Lumbar Vertebrae (diagnostic imaging, surgery); Treatment Outcome

Publication Date

1-1-2023

Publication Title

Neurosurgical focus

E-ISSN

1092-0684

Volume

54

Issue

1

First Page

E3

PubMed ID

36587405

Digital Object Identifier (DOI)

10.3171/2022.10.FOCUS22603

Link to Full Text

Share

COinS