Neurosurgeon Acadiana Neurosurgery Lafayette, Louisiana, United States
Introduction: Minimally invasive anterolateral approaches to the lumbar spine are options for the treatment of a number of adult degenerative spinal disorders. Dissection and dilation through the iliopsoas muscle places the lumbosacral plexus at risk for injury and potential devastating complications. A new technique of MIS single position prone lateral surgery using a low profile system composed of smaller pedicle screws, 4.5mm molybdenum-rhenium rods and specialized lateral retractor can reduce the frequency of complications associated with lateral approaches.
Methods: This was a retrospective, single center, case series. Inclusion criteria were adult (≥ 18 ) patients who underwent a prone lateral MIS LIF with the low profile molybdenum-rhenium system. Intraoperative and postoperative adverse events immediately after surgery and during routine follow-up intervals were examined.
Results: Twenty-four (24) patients that had spinal surgery from March 2020 until November 2022 met the inclusion criteria. The patients’ mean age was 64 ±8.9 years; 37.5% were women; 41.7% were smokers; 4.2% were diabetic with a mean body mass index (BMI) of 31.6 ±7.8.0. The mean number of levels fused was 1.7 ±1.2 with an average EBL of 123.9 cc. There were no occurrences [0% (0/24)] of postoperative ipsilateral thigh numbness or weakness.
Conclusion : The MIS single position prone lateral approach is a safe alternative to traditional open, direct lateral and extreme lateral operations for many spinal disorders. Our refined technique of MIS Prone Lateral using a low profile molybdenum-rhenium system resulted in excellent safety without occurrence of postoperative ipsilateral thigh numbness, ipsilateral iliopsoas or quadriceps weakness.
