Comparison of segmental lordosis gain of prone transpsoas (PTP) vs. lateral lumbar interbody fusion

Introduction Lumbar interbody fusion is a standard method to treat certain degenerative conditions that are refractory to conservative treatments. LLIF reduces posterior muscle damage, can relieve neurological symptoms through indirect decompression, provides increased stability with its wider cages...

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Published in:Archives of orthopaedic and trauma surgery 2023-09, Vol.143 (9), p.5485-5490
Main Authors: Amaral, Rodrigo, Moriguchi, Rafael, Pokorny, Gabriel, Arnoni, Daniel, Barreira, Igor, Marcelino, Fernando, Pokorny, Jullyene, Pimenta, Luiz
Format: Article
Language:English
Subjects:
Archives & records
Medicine
Medicine & Public Health
Orthopaedic Surgery
Orthopedics
Patients
Surgeons
Surgery
Tomography
Variables
X-rays
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Summary:Introduction Lumbar interbody fusion is a standard method to treat certain degenerative conditions that are refractory to conservative treatments. LLIF reduces posterior muscle damage, can relieve neurological symptoms through indirect decompression, provides increased stability with its wider cages, and promotes more significant segmental lordosis than standard posterior techniques. However, the technique possesses its issues, such as unusual positioning, possible plexus-related symptoms, and median segmental lordosis correction. Trying to ease those issues, the idea of a prone transpsoas technique occurred. Methods Retrospective, single-centric, comparative, and non-randomized study. The authors paired patients receiving lateral lumbar interbody fusion (LLIF) or prone transpsoas (PTP) to evaluate the technique’s impact on the segmental lordosis correction. A correlation test selected the covariates for the matching. p -Values inferior to 0.05 were deemed significant. Results Seventy-one patients were included in the analysis, 53 in the LLIF group and 18 in the PTP group. The significant covariates to the segmental lordosis correction were technique, preoperative segmental lordosis, cage position, and preoperative pelvic tilt. After the paring model, PTP showed significant segmental lordosis correction potential regarding the LLIF. Conclusion The prone transpsoas approach can significantly enhance the correction of segmental lordosis proportionated to the traditional LLIF approach.
ISSN:1434-3916
0936-8051
1434-3916
DOI:10.1007/s00402-023-04821-1