Prone vs lateral decubitus position extreme lateral interbody fusion had similar outcomes
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Published results showed patients who underwent prone single-position extreme lateral interbody fusion had comparable clinical results to the standard, lateral decubitus position with a reduction in overall surgical time.
Pedro Berjano, MD, PhD, and colleagues compared duration of surgery, blood loss, complications, X-ray use and clinical outcomes between seven patients who underwent prone single-position extreme lateral interbody fusion (Pro-XLIF) and 10 patients who underwent standard, lateral decubitus position extreme lateral interbody fusion (Std-XLIF).
Results showed no major complications among either group. Researchers found improvements in the Oswestry Disability Index from 48.5 to 14.5 in the Pro-XLIF group and from 50.8 to 22.5 in the Std-XLIF group. The Pro-XLIF group also had improved back pain from 7.7 to 1.71 and leg pain from 8.5 to 2.71, while the Std-XLIF group had improved back pain from 5.7 to 3.7 and leg pain from 7.2 to 2.5, according to results. Researchers noted longer time of preparation before incision and longer X-ray exposure time in the Pro-XLIF group compared with the Std-XLIF group. However, results showed the groups had equal duration of the anterior procedure and patients in the Pro-XLIF group had shorter duration of surgery.
“XLIF in the prone position provides new opportunities of adoption for those surgeons who feel more comfortable handling the anatomy and pathology in the prone position,” Berjano told Healio Orthopedics. “Most importantly, Pro-XLIF ([or] XLIF in the prone position) opens new applications of minimally invasive, anterior interbody fusion to deformity and revision cases, potentially improving the control of sagittal alignment, allowing simultaneous manipulation of the anterior and posterior column, and avoiding multiple changes of position in revision cases (needing posterior implant replacement, anterior interbody implant, posterior column osteotomies and final fixation).” – by Casey Tingle
Disclosures: Berjano reports he received honorarium as a consultant from Nuvasive, DePuy Synthes, Medacta and K2M, and royalties from Nuvasive. Please see the study for all other authors’ relevant financial disclosures.
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