{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:18:05Z","timestamp":1792034285260,"version":"4.4.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Lateral lumbar interbody fusion (LLIF) is a workhorse surgical approach for lumbar arthrodesis. There is growing interest in techniques for performing single-position surgery in which LLIF and pedicle screw fixation are performed with the patient in the prone position. Most studies of prone LLIF are of poor quality and without long-term follow-up; therefore, the complication profile related to this novel approach is not well known. The objective of this study was to perform a systematic review and pooled analysis to understand the safety profile of prone LLIF.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A systematic review of the literature and a pooled analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies reporting prone LLIF were assessed for inclusion. Studies not reporting complication rates were excluded.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Ten studies meeting the inclusion criteria were analyzed. Overall, 286 patients were treated with prone LLIF across these studies, and a mean (SD) of 1.3 (0.2) levels per patient were treated. The 18 intraoperative complications reported included cage subsidence (3.8% [3\/78]), anterior longitudinal ligament rupture (2.3% [5\/215]), cage repositioning (2.1% [2\/95]), segmental artery injury (2.0% [5\/244]), aborted prone interbody placement (0.8% [2\/244]), and durotomy (0.6% [1\/156]). No major vascular or peritoneal injuries were reported. Sixty-eight postoperative complications occurred, including hip flexor weakness (17.8% [21\/118]), thigh and groin sensory symptoms (13.3% [31\/233]), revision surgery (3.8% [3\/78]), wound infection (1.9% [3\/156]), psoas hematoma (1.3% [2\/156]), and motor neural injury (1.2% [2\/166]).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Single-position LLIF in the prone position appears to be a safe surgical approach with a low complication profile. Longer-term follow-up and prospective studies are needed to better characterize the long-term complication rates related to this approach.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.4.spine221180","type":"journal-article","created":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T16:53:50Z","timestamp":1685811230000},"page":"380-386","source":"Crossref","is-referenced-by-count":17,"title":["Complications associated with single-position prone lateral lumbar interbody fusion: a systematic review and pooled analysis"],"prefix":"10.3171","volume":"39","author":[{"given":"S. Harrison","family":"Farber","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayron","family":"Valenzuela Cecchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke K.","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina M.","family":"Chapple","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nima","family":"Alan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy C.","family":"Gooldy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D.","family":"DiDomenico","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay D.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan S.","family":"Uribe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Clin Neurol Neurosurg","first-page":"122","article-title":"Outcomes following minimally invasive lateral transpsoas interbody fusion for degenerative low grade lumbar spondylolisthesis: a systematic review","volume":"167","author":"Goyal A","year":"2018","unstructured":"Goyal A, Kerezoudis P, Alvi MA, Goncalves S, Bydon M. Outcomes following minimally invasive lateral transpsoas interbody fusion for degenerative low grade lumbar spondylolisthesis: a systematic review. Clin Neurol Neurosurg. 2018;167:122\u2013128."},{"issue":"suppl 3","key":"b2","series-title":"Eur Spine J","first-page":"287","article-title":"MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics","volume":"24","author":"Lehmen JA","year":"2015","unstructured":"Lehmen JA, Gerber EJ. MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics. Eur Spine J. 2015;24(suppl 3):287-313."},{"issue":"4","key":"b3","series-title":"J Neurosurg Spine","first-page":"446","article-title":"Complications for minimally invasive lateral interbody arthrodesis: a systematic review and meta-analysis comparing prepsoas and transpsoas approaches","volume":"30","author":"Walker CT","year":"2019","unstructured":"Walker CT, Farber SH, Cole TS,  Complications for minimally invasive lateral interbody arthrodesis: a systematic review and meta-analysis comparing prepsoas and transpsoas approaches. J Neurosurg Spine. 2019;30(4):446\u2013460."},{"key":"b4","series-title":"World Neurosurg","first-page":"599","article-title":"Subsidence rates after lateral lumbar interbody fusion: a systematic review","volume":"122","author":"Macki M","year":"2019","unstructured":"Macki M, Anand SK, Surapaneni A, Park P, Chang V. Subsidence rates after lateral lumbar interbody fusion: a systematic review. World Neurosurg. 2019;122:599\u2013606."},{"key":"b5","series-title":"World Neurosurg","first-page":"e786","article-title":"Single-position prone lateral interbody fusion improves segmental lordosis in lumbar spondylolisthesis","volume":"151","author":"Walker CT","year":"2021","unstructured":"Walker CT, Farber SH, Gandhi S, Godzik J, Turner JD, Uribe JS. Single-position prone lateral interbody fusion improves segmental lordosis in lumbar spondylolisthesis. World Neurosurg. 2021;151:e786\u2013e792."},{"issue":"5-6","key":"b6","series-title":"Minim Invasive Neurosurg","first-page":"201","article-title":"Evaluation of indirect decompression of the lumbar spinal canal following minimally invasive lateral transpsoas interbody fusion: radiographic and outcome analysis","volume":"54","author":"Elowitz EH","year":"2011","unstructured":"Elowitz EH, Yanni DS, Chwajol M, Starke RM, Perin NI. Evaluation of indirect decompression of the lumbar spinal canal following minimally invasive lateral transpsoas interbody fusion: radiographic and outcome analysis. Minim Invasive Neurosurg. 2011;54(5-6):201\u2013206."},{"issue":"1","key":"b7","series-title":"J Neurosurg Spine","first-page":"80","article-title":"Predictors of indirect neural decompression in minimally invasive transpsoas lateral lumbar interbody fusion","volume":"35","author":"Walker CT","year":"2021","unstructured":"Walker CT, Xu DS, Cole TS,  Predictors of indirect neural decompression in minimally invasive transpsoas lateral lumbar interbody fusion. J Neurosurg Spine. 2021;35(1):80\u201390."},{"issue":"3","key":"b8","series-title":"J Neurosurg Spine","first-page":"416","article-title":"Perioperative outcomes and adverse events of minimally invasive versus open posterior lumbar fusion: meta-analysis and systematic review","volume":"24","author":"Goldstein CL","year":"2016","unstructured":"Goldstein CL, Macwan K, Sundararajan K, Rampersaud YR. Perioperative outcomes and adverse events of minimally invasive versus open posterior lumbar fusion: meta-analysis and systematic review. J Neurosurg Spine. 2016;24(3):416\u2013427."},{"issue":"4","key":"b9","series-title":"Spine J","first-page":"435","article-title":"Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion","volume":"6","author":"Ozgur BM","year":"2006","unstructured":"Ozgur BM, Aryan HE, Pimenta L, Taylor WR. Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J. 2006;6(4):435\u2013443."},{"issue":"3","key":"b10","series-title":"J Neurosurg Spine","first-page":"358","article-title":"Single-position prone lateral transpsoas approach: early experience and outcomes","volume":"36","author":"Farber SH","year":"2022","unstructured":"Farber SH, Naeem K, Bhargava M, Porter RW. Single-position prone lateral transpsoas approach: early experience and outcomes. J Neurosurg Spine. 2022;36(3):358\u2013365."},{"issue":"1 suppl 1","key":"b11","series-title":"Eur Spine J","first-page":"6","article-title":"Prone single-position extreme lateral interbody fusion (Pro-XLIF): preliminary results","volume":"29","author":"Lamartina C","year":"2020","unstructured":"Lamartina C, Berjano P. Prone single-position extreme lateral interbody fusion (Pro-XLIF): preliminary results. Eur Spine J. 2020;29(1 suppl 1):6\u201313."},{"issue":"3","key":"b12","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Single-position prone lateral approach: cadaveric feasibility study and early clinical experience","volume":"49","author":"Godzik J","year":"2020","unstructured":"Godzik J, Ohiorhenuan IE, Xu DS,  Single-position prone lateral approach: cadaveric feasibility study and early clinical experience. Neurosurg Focus. 2020;49(3):E15."},{"key":"b13","series-title":"J Vis Exp","first-page":"e62662","article-title":"Three-dimensional navigation-guided, prone, single-position, lateral lumbar interbody fusion technique","volume":"173","author":"Hoffman SE","year":"2021","unstructured":"Hoffman SE, Gupta S, Huang K,  Three-dimensional navigation-guided, prone, single-position, lateral lumbar interbody fusion technique. J Vis Exp. 2021;173:e62662."},{"issue":"1","key":"b14","series-title":"J Neurosurg Spine","first-page":"92","article-title":"Outpatient outcomes of patients with femoral nerve neurapraxia after prone lateral lumbar interbody fusion at L4\u20135","volume":"37","author":"Morgan CD","year":"2022","unstructured":"Morgan CD, Katsevman GA, Godzik J,  Outpatient outcomes of patients with femoral nerve neurapraxia after prone lateral lumbar interbody fusion at L4\u20135. J Neurosurg Spine. 2022;37(1):92\u201395."},{"issue":"2","key":"b15","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E119","article-title":"Prone single-position lateral lumbar interbody fusion with posterior decompression and pedicle screw fixation for the treatment of grade II spondylolisthesis: 2-dimensional operative video","volume":"21","author":"Naeem K","year":"2021","unstructured":"Naeem K, Farber SH, Bhargava M, Porter RW. Prone single-position lateral lumbar interbody fusion with posterior decompression and pedicle screw fixation for the treatment of grade II spondylolisthesis: 2-dimensional operative video. Oper Neurosurg (Hagerstown). 2021;21(2):E119\u2013E120."},{"key":"b16","series-title":"World Neurosurg","first-page":"221","article-title":"Navigation and robotic-assisted single-position prone lateral lumbar interbody fusion: technique, feasibility, safety, and case series","volume":"152","author":"North RY","year":"2021","unstructured":"North RY, Strong MJ, Yee TJ, Kashlan ON, Oppenlander ME, Park P. Navigation and robotic-assisted single-position prone lateral lumbar interbody fusion: technique, feasibility, safety, and case series. World Neurosurg. 2021;152:221\u2013230.e1."},{"issue":"1","key":"b17","series-title":"Eur Spine J","first-page":"108","article-title":"The prone transpsoas technique: preliminary radiographic results of a multicenter experience","volume":"30","author":"Pimenta L","year":"2021","unstructured":"Pimenta L, Amaral R, Taylor W,  The prone transpsoas technique: preliminary radiographic results of a multicenter experience. Eur Spine J. 2021;30(1):108\u2013113."},{"key":"b18","series-title":"World Neurosurg","first-page":"e664","article-title":"Single-position prone transpsoas lateral interbody fusion including L4L5: early postoperative outcomes","volume":"149","author":"Pimenta L","year":"2021","unstructured":"Pimenta L, Pokorny G, Amaral R,  Single-position prone transpsoas lateral interbody fusion including L4L5: early postoperative outcomes. World Neurosurg. 2021;149:e664\u2013e668."},{"issue":"1","key":"b19","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E5","article-title":"Prone transpsoas technique for simultaneous single-position access to the anterior and posterior lumbar spine","volume":"20","author":"Pimenta L","year":"2020","unstructured":"Pimenta L, Taylor WR, Stone LE, Wali AR, Santiago-Dieppa DR. Prone transpsoas technique for simultaneous single-position access to the anterior and posterior lumbar spine. Oper Neurosurg (Hagerstown). 2020;20(1):E5\u2013E12."},{"key":"b20","series-title":"N Am Spine Soc J","first-page":"100056","article-title":"Initial multi-centre clinical experience with prone transpsoas lateral interbody fusion: feasibility, perioperative outcomes, and lessons learned","volume":"6","author":"Smith TG","year":"2021","unstructured":"Smith TG, Joseph SA Jr, Ditty B,  Initial multi-centre clinical experience with prone transpsoas lateral interbody fusion: feasibility, perioperative outcomes, and lessons learned. N Am Spine Soc J. 2021;6:100056."},{"key":"b21","series-title":"Clin Neurol Neurosurg","first-page":"107105","article-title":"Comparison of prone transpsoas lateral lumbar interbody fusion and transforaminal lumbar interbody fusion for degenerative lumbar spine disease: a retrospective radiographic propensity score-matched analysis","volume":"213","author":"Soliman MAR","year":"2022","unstructured":"Soliman MAR, Aguirre AO, Ruggiero N,  Comparison of prone transpsoas lateral lumbar interbody fusion and transforaminal lumbar interbody fusion for degenerative lumbar spine disease: a retrospective radiographic propensity score-matched analysis. Clin Neurol Neurosurg. 2022;213:107105."},{"key":"b22","series-title":"World Neurosurg","first-page":"e11","article-title":"Comparison of prone transpsoas and standard lateral lumbar interbody fusion surgery for degenerative lumbar spine disease: a retrospective radiographic propensity score-matched analysis","volume":"157","author":"Soliman MAR","year":"2022","unstructured":"Soliman MAR, Khan A, Pollina J. Comparison of prone transpsoas and standard lateral lumbar interbody fusion surgery for degenerative lumbar spine disease: a retrospective radiographic propensity score-matched analysis. World Neurosurg. 2022;157:e11\u2013e21."},{"issue":"71","key":"b23","series-title":"BMJ","first-page":"n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM,  The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372(71):n71."},{"issue":"4","key":"b24","series-title":"J Clin Epidemiol","first-page":"401","article-title":"GRADE guidelines: 3. Rating the quality of evidence","volume":"64","author":"Balshem H","year":"2011","unstructured":"Balshem H, Helfand M, Sch\u00fcnemann HJ,  GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401\u2013406."},{"issue":"9","key":"b25","series-title":"Eur Spine J","first-page":"2220","article-title":"Anatomical positional changes in the lateral lumbar interbody fusion","volume":"31","author":"Gandhi SV","year":"2022","unstructured":"Gandhi SV, Dugan R, Farber SH, Godzik J, Alhilali L, Uribe JS. Anatomical positional changes in the lateral lumbar interbody fusion. Eur Spine J. 2022;31(9):2220\u20132226."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/3\/article-p380.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/3\/article-p380.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/3\/article-p380.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:13:48Z","timestamp":1733490828000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/3\/article-p380.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,1]]},"references-count":25,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2023.4.spine221180","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9,1]]}}}