J Neurosurg Spine 42:768–774, 2025
Single-position prone lateral lumbar interbody fusion (LLIF+PPS) reduces operating room time and costs compared to dual-position surgery, especially for 2-level fusions, while maintaining similar hospital stays and clinical outcomes. Cost savings are most significant in complex, multilevel cases due to eliminated patient repositioning.
• Single-position (SP) prone lateral lumbar interbody fusion (LLIF) eliminates patient repositioning compared to dual-position (DP) LLIF+PPS.
• Study compared costs, operating room (OR) time, and hospital stay between SP and DP LLIF+PPS for 1- and 2-level fusions.
• For 2-level fusions, SP surgery had significantly shorter OR time, lower OR and anesthesiology costs than DP surgery.
• For 1-level fusions, differences in OR time and costs between SP and DP were not statistically significant.
• Hospital length of stay was similar between SP and DP groups for both 1- and 2-level fusions.
• Both approaches showed similar safety, fusion rates, and patient-reported outcomes after at least 1 year.
• SP prone LLIF+PPS is most beneficial for complex, multi-level cases, offering efficiency and cost savings.
• Further studies with larger cohorts are needed to confirm these findings.

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