Introduction

The lateral lumbar interbody fusion (LLIF) is a safe and effective technique to treat a vast range of lumbar disorders. However, the technique is also burdened by some problems. A new approach to the lateral lumbar interbody fusion was devised to solve or reduce some of the problems regarding the lateral approach. Its principal difference from the standard LLIF relies on positioning the patient in a prone decubitus, which might lead to an increase in the intradiscal lordosis.

Methods

A retrospective, multicentric, non-randomized study to evaluate segmental and regional lordosis following prone transpsoas (PTP) approach to LLIF. All patients undergoing prone transpsoas surgery at the involved institutions were included. Patients with low-quality images not allowing the measurements of the required spinopelvic parameters were excluded. Measurements included pre- and postoperative index-level segmental lordosis, lumbar lordosis, pelvic incidence, and pelvic tilt.

Results

Thirty-two (32) patients were included in the study, in which 23 underwent single-level, six (6) underwent two-level, Two (2) underwent three-level, and one underwent four-level PTP. Mean index level segmental lordosis increased from 8.7° to 14.8°(p < 0.001); lumbar lordosis (L1-S1) increased from 42.1° to 45.8° (p = 0.11), although after excluding an outlier value L1-S1 lordosis results were 41.9° pre-op to 46.7° post-op (p = 0.003). Twenty-two (22) patients had a pre-op PI-LL mismatch of 10° or more, while at the postoperative visit, only 12 patients had a mismatch outside of 10° (p = 0.01).

Conclusion

The prone transpsoas technique is feasible and is associated with a significant gain of segmental lordosis and correction of spinopelvic alignment parameters.

中文翻译：

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俯卧的掌骨技术：多中心经验的初步影像学结果。

介绍

外侧腰椎椎间融合术（LLIF）是一种安全有效的技术，可治疗各种腰椎疾病。但是，该技术还存在一些问题。设计了一种新的外侧腰椎椎间融合术，以解决或减少一些与外侧椎弓根入路有关的问题。它与标准LLIF的主要区别在于将患者置于俯卧的位置，这可能导致椎间盘突出症的增加。

方法

一项回顾性，多中心，非随机的研究，以评估俯卧透骨法（PTP）治疗LLIF后的节段性和区域性脊柱前凸。包括所有在相关机构接受俯卧穿骨手术的患者。排除无法进行所需骨盆腔参数测量的低质量图像的患者。测量包括术前和术后指标水平的节段性脊柱前凸，腰椎前凸，骨盆发生率和骨盆倾斜度。

结果

这项研究包括了三十二（32）名患者，其中23例接受了单级治疗，六（6）例接受了两级治疗，两（2）例接受了三级治疗，一例接受了四级治疗。平均指数水平节段性脊柱前凸从8.7°增至14.8°（p  <0.001）; 腰椎前凸（L1-S1）从42.1°增加到45.8°（p  = 0.11），尽管排除异常值L1-S1前凸后，结果是手术前41.9°至手术后46.7°（p  = 0.003）。22（22）例患者术前PI-LL错配为10°或以上，而在术后访视时，只有12例患者PI-LL错配在10°以外（p  = 0.01）。

结论

俯卧经骨技术是可行的，并且与节段性脊柱前凸的显着增加和脊柱骨盆定位参数的校正有关。