Single-Position Fluoroscopy-Guided Lateral Lumbar Interbody Fusion With Intraoperative Computed Tomography-Navigated Posterior Pedicle Screw Fixation: Technical Report and Literature Review

. 2022 Apr;16(S1):S9-S16.


doi: 10.14444/8231.

Affiliations

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Jacob L Goldberg et al.


Int J Spine Surg.


2022 Apr.

Abstract

Lateral lumbar interbody fusion (LLIF) is a powerful tool in minimally invasive spine surgery with high rates of fusion, excellent indirect decompression, and deformity correction. LLIF offers advantages compared with anterior lumbar interbody fusion including a more favorable complication profile. Traditionally, the interbody fusion is performed in the lateral position and fluoroscopy-assisted pedicle screw fixation performed with the patient repositioned prone. The evolution of both pedicle screw technology and intraoperative navigation has enhanced the feasibility of single (lateral)-position surgery. Early reports using fluoroscopy-assisted pedicle screws and computer or robotic navigation suggest this technique can be performed safely and accurately. The purpose of this brief report is to provide the technical steps, workflow, as well as pearls and pitfalls for single-position LLIF with true intraoperative computed tomography navigation-guided percutaneous pedicle screw fixation. A case example is included for illustration.


Keywords:

LLIF; intraoperative navigation; single-position lateral lumbar interbody fusion.

Conflict of interest statement

Declaration of Conflicting Interests: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest with the exception of the following: Roger Härtl reports consulting fees from DePuy Synthes, Brainlab, and Ulrich; royalties from Zimmer Biomet; and other relationship (advisor) with RealSpine.

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