Clinical Outcomes and Radiographic Results of Prone Transpsoas Lateral Lumbar Interbody Fusion

Neurosurgery 96:763–768, 2025

The study evaluates the prone transpsoas (PTP) approach for lateral lumbar interbody fusion, showing improved lumbar lordosis, reduced complications, and enhanced patient-reported outcomes. Conducted on 106 patients, the approach minimized operative time and demonstrated safety and efficacy in lumbar fusion.

Clinical Research Summary

• Study Focus: Prone transpsoas lateral lumbar interbody fusion (PTP) for lumbar fusion.

• Study Design: Retrospective observational study of 106 patients, single-surgeon series.

• Patient Demographics: Mean age 66 years, mean BMI 29.3, follow-up 13 months.

• Surgical Technique: Prone positioning, single-position access to anterior/posterior lumbar spine.

• Common Levels: The most common level treated was L4-5.

• Outcomes: Improved lumbar lordosis, reduced pelvic tilt, and decreased PI-LL mismatch.

• Complications: Minimal, with transient hip flexor weakness in 0.9% of patients.

• Pain Scores: VAS pain scores improved from 6 to 5 postoperatively.

• Surgical Indications: Degenerative scoliosis, spondylolisthesis, disk disease, adjacent segment disease, pseudoarthrosis.

• Adverse Events: No bowel or major vessel injuries were reported.

• Radiographic Results: Significant improvement in lumbar lordosis and pelvic parameters.

• Limitations: Single-surgeon study, short follow-up, retrospective data collection.

• Conclusion: PTP approach is safe and effective for lumbar fusion with minimal complications.