{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:28:14Z","timestamp":1790998094659,"version":"4.1.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The objective of this study was to determine efficiencies associated with dual-position versus single-position lateral lumbar interbody fusion (LLIF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Billing databases were queried for LLIF procedures performed by a single surgeon at a high-volume tertiary care center. Case-specific costs for each procedure were collected. Cases were matched by the number of levels treated. One-level and 2-level LLIFs with percutaneous pedicle screw (PPS) fixation (LLIF+PPS) using a single vendor system were included. Length of stay, operative time, and operative costs were compared for dual-position and single-position LLIF cases using continuous and categorical variable comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 9 patients with 1-level LLIF+PPS, dual-position LLIF+PPS (n = 3) compared with single-position LLIF+PPS (n = 6) was associated with similar mean lengths of stay (2.0 vs 2.2 days), longer operating room time (160.1 vs 149.7 minutes), and greater mean costs for operating room staff and supplies ($1347 vs $1263); however, the differences were not statistically significant. Time-based anesthesiology costs were higher for dual-position LLIF+PPS than for single-position LLIF+PPS ($741 vs $521, p = 0.03). Among 8 patients with 2-level LLIF+PPS, patients undergoing dual-position (n = 5) and single-position (n = 3) LLIF+PPS had similar mean lengths of stay (1.2 vs 1.5 days). However, dual-position surgery was associated with a longer mean operating room time (257.8 vs 182.3 minutes, p = 0.03), greater mean operating room cost ($2275 vs $1352, p = 0.02), and greater time-based cost of anesthesiology coverage ($864 vs $644, p = 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In this cohort of patients undergoing 1- and 2-level LLIF+PPS, single-position surgery was associated with shorter operating room time, lower operating room costs, and similar postoperative hospital length of stay when compared with dual-position surgery for a similar pathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.11.spine23706","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T16:49:52Z","timestamp":1743266992000},"page":"768-774","source":"Crossref","is-referenced-by-count":4,"title":["Cost and operating room time savings with single-position prone lateral lumbar interbody circumferential fusion"],"prefix":"10.3171","volume":"42","author":[{"given":"Jonathan J.","family":"Lee","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":"Juan P.","family":"Giraldo","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":"Clinton D.","family":"Morgan","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":"Gennadiy A.","family":"Katsevman","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":"Stefan W.","family":"Koester","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":"Robert K.","family":"Dugan","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":"Joshua S.","family":"Catapano","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":"S. Harrison","family":"Farber","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":"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."},{"key":"b2","series-title":"World Neurosurg","first-page":"e705","article-title":"Effects of surgical positioning on L4-L5 accessibility and lumbar lordosis in lateral transpsoas lumbar interbody fusion: a comparison of prone and lateral decubitus in asymptomatic adults","volume":"149","author":"Smith TG","year":"2021","unstructured":"Smith TG, Pollina J, Joseph SA Jr, Howell KM. Effects of surgical positioning on L4-L5 accessibility and lumbar lordosis in lateral transpsoas lumbar interbody fusion: a comparison of prone and lateral decubitus in asymptomatic adults. World Neurosurg. 2021;149:e705\u2013e713."},{"issue":"1","key":"b3","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":"b4","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."},{"key":"b5","series-title":"World Neurosurg","first-page":"e131","article-title":"The effect of patient position on psoas morphology and in lumbar lordosis","volume":"153","author":"Amaral R","year":"2021","unstructured":"Amaral R, Daher MT, Pratali R,  The effect of patient position on psoas morphology and in lumbar lordosis. World Neurosurg. 2021;153:e131\u2013e140."},{"issue":"6","key":"b6","series-title":"J Spinal Disord","first-page":"461","article-title":"The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis","volume":"6","author":"Bridwell KH","year":"1993","unstructured":"Bridwell KH, Sedgewick TA, O\u2019Brien MF, Lenke LG, Baldus C. The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis. J Spinal Disord. 1993;6(6):461\u2013472."},{"issue":"6","key":"b7","series-title":"Value Health","first-page":"810","article-title":"A cost-effectiveness analysis of minimally invasive versus open surgery techniques for lumbar spinal fusion in Italy and the United Kingdom","volume":"18","author":"Vertuani S","year":"2015","unstructured":"Vertuani S, Nilsson J, Borgman B,  A cost-effectiveness analysis of minimally invasive versus open surgery techniques for lumbar spinal fusion in Italy and the United Kingdom. Value Health. 2015;18(6):810\u2013816."},{"issue":"1 suppl","key":"b8","series-title":"Global Spine J","first-page":"30S","article-title":"Is less really more? Economic evaluation of minimally invasive surgery","volume":"11","author":"Chung AS","year":"2021","unstructured":"Chung AS, Ballatori A, Ortega B,  Is less really more? Economic evaluation of minimally invasive surgery. Global Spine J. 2021;11(1 suppl):30S\u201336S."},{"issue":"6","key":"b9","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Cost-effectiveness analysis in minimally invasive spine surgery","volume":"36","author":"Al-Khouja LT","year":"2014","unstructured":"Al-Khouja LT, Baron EM, Johnson JP, Kim TT, Drazin D. Cost-effectiveness analysis in minimally invasive spine surgery. Neurosurg Focus. 2014;36(6):E4."},{"issue":"2","key":"b10","series-title":"Spine J","first-page":"339","article-title":"The cost effectiveness of minimally invasive spine surgery in the treatment of adult degenerative scoliosis: a comparison of transpsoas and open techniques","volume":"19","author":"Swamy G","year":"2019","unstructured":"Swamy G, Lopatina E, Thomas KC, Marshall DA, Johal HS. The cost effectiveness of minimally invasive spine surgery in the treatment of adult degenerative scoliosis: a comparison of transpsoas and open techniques. Spine J. 2019;19(2):339\u2013348."},{"issue":"1","key":"b11","series-title":"Global Spine J","first-page":"39","article-title":"Cost analysis of single-level lumbar fusions","volume":"10","author":"Beckerman D","year":"2020","unstructured":"Beckerman D, Esparza M, Lee SI,  Cost analysis of single-level lumbar fusions. Global Spine J. 2020;10(1):39\u201346."},{"issue":"5","key":"b12","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E369","article-title":"Single-position surgery: prone lateral lumbar interbody fusion: 2-dimensional operative video","volume":"20","author":"Ohiorhenuan IE","year":"2021","unstructured":"Ohiorhenuan IE, Godzik J, Uribe JS. Single-position surgery: prone lateral lumbar interbody fusion: 2-dimensional operative video. Oper Neurosurg (Hagerstown). 2021;20(5):E369."},{"issue":"1","key":"b13","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":"b14","series-title":"World Neurosurg","first-page":"170","article-title":"Prone lateral lumbar interbody fusion: case report and technical note","volume":"144","author":"Martirosyan NL","year":"2020","unstructured":"Martirosyan NL, Uribe JS, Randolph BM, Buchanan RI. Prone lateral lumbar interbody fusion: case report and technical note. World Neurosurg. 2020;144:170\u2013177."},{"key":"b1","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."},{"key":"b2","series-title":"World Neurosurg","first-page":"e705","article-title":"Effects of surgical positioning on L4-L5 accessibility and lumbar lordosis in lateral transpsoas lumbar interbody fusion: a comparison of prone and lateral decubitus in asymptomatic adults","volume":"149","author":"Smith TG","year":"2021","unstructured":"Smith TG, Pollina J, Joseph SA Jr, Howell KM. Effects of surgical positioning on L4-L5 accessibility and lumbar lordosis in lateral transpsoas lumbar interbody fusion: a comparison of prone and lateral decubitus in asymptomatic adults. World Neurosurg. 2021;149:e705\u2013e713."},{"issue":"1","key":"b3","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":"b4","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."},{"key":"b5","series-title":"World Neurosurg","first-page":"e131","article-title":"The effect of patient position on psoas morphology and in lumbar lordosis","volume":"153","author":"Amaral R","year":"2021","unstructured":"Amaral R, Daher MT, Pratali R,  The effect of patient position on psoas morphology and in lumbar lordosis. World Neurosurg. 2021;153:e131\u2013e140."},{"issue":"6","key":"b6","series-title":"J Spinal Disord","first-page":"461","article-title":"The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis","volume":"6","author":"Bridwell KH","year":"1993","unstructured":"Bridwell KH, Sedgewick TA, O\u2019Brien MF, Lenke LG, Baldus C. The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis. J Spinal Disord. 1993;6(6):461\u2013472."},{"issue":"6","key":"b7","series-title":"Value Health","first-page":"810","article-title":"A cost-effectiveness analysis of minimally invasive versus open surgery techniques for lumbar spinal fusion in Italy and the United Kingdom","volume":"18","author":"Vertuani S","year":"2015","unstructured":"Vertuani S, Nilsson J, Borgman B,  A cost-effectiveness analysis of minimally invasive versus open surgery techniques for lumbar spinal fusion in Italy and the United Kingdom. Value Health. 2015;18(6):810\u2013816."},{"issue":"1 suppl","key":"b8","series-title":"Global Spine J","first-page":"30S","article-title":"Is less really more? Economic evaluation of minimally invasive surgery","volume":"11","author":"Chung AS","year":"2021","unstructured":"Chung AS, Ballatori A, Ortega B,  Is less really more? Economic evaluation of minimally invasive surgery. Global Spine J. 2021;11(1 suppl):30S\u201336S."},{"issue":"6","key":"b9","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Cost-effectiveness analysis in minimally invasive spine surgery","volume":"36","author":"Al-Khouja LT","year":"2014","unstructured":"Al-Khouja LT, Baron EM, Johnson JP, Kim TT, Drazin D. Cost-effectiveness analysis in minimally invasive spine surgery. Neurosurg Focus. 2014;36(6):E4."},{"issue":"2","key":"b10","series-title":"Spine J","first-page":"339","article-title":"The cost effectiveness of minimally invasive spine surgery in the treatment of adult degenerative scoliosis: a comparison of transpsoas and open techniques","volume":"19","author":"Swamy G","year":"2019","unstructured":"Swamy G, Lopatina E, Thomas KC, Marshall DA, Johal HS. The cost effectiveness of minimally invasive spine surgery in the treatment of adult degenerative scoliosis: a comparison of transpsoas and open techniques. Spine J. 2019;19(2):339\u2013348."},{"issue":"1","key":"b11","series-title":"Global Spine J","first-page":"39","article-title":"Cost analysis of single-level lumbar fusions","volume":"10","author":"Beckerman D","year":"2020","unstructured":"Beckerman D, Esparza M, Lee SI,  Cost analysis of single-level lumbar fusions. Global Spine J. 2020;10(1):39\u201346."},{"issue":"5","key":"b12","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E369","article-title":"Single-position surgery: prone lateral lumbar interbody fusion: 2-dimensional operative video","volume":"20","author":"Ohiorhenuan IE","year":"2021","unstructured":"Ohiorhenuan IE, Godzik J, Uribe JS. Single-position surgery: prone lateral lumbar interbody fusion: 2-dimensional operative video. Oper Neurosurg (Hagerstown). 2021;20(5):E369."},{"issue":"1","key":"b13","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":"b14","series-title":"World Neurosurg","first-page":"170","article-title":"Prone lateral lumbar interbody fusion: case report and technical note","volume":"144","author":"Martirosyan NL","year":"2020","unstructured":"Martirosyan NL, Uribe JS, Randolph BM, Buchanan RI. Prone lateral lumbar interbody fusion: case report and technical note. World Neurosurg. 2020;144:170\u2013177."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/42\/6\/article-p768.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/42\/6\/article-p768.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/42\/6\/article-p768.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:45:07Z","timestamp":1772804707000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/42\/6\/article-p768.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,1]]},"references-count":28,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2024.11.spine23706","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,6,1]]}}}