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Key Considerations in Surgical Decision-Making on the Side of Approach for Lumbar Lateral Transpsoas Interbody Fusion Techniques

Year: 2025

Type: article

Abstract: OBJECTIVES: Lumbar lateral transpsoas interbody fusion is a powerful technique for addressing various spinal pathologies, enabling effective anterior column reconstruction. A critical decision in performing this procedure is selecting the appropriate side for the approach to the lumbar spine, whether in the prone or lateral decubitus position. This article outlines a decision-making framework to assist surgeons in deciding the optimal approach for direct lateral surgery to achieve the desired surgical outcome. STUDY DESIGN: Technical note for lateral spinal fusion approaches. METHODS: The article explores anatomical considerations, surgical indications, and patient-specific factors relevant to the choice of approach in lateral lumbar transpsoas fusions. Through case examples, various factors influencing side selection are discussed. RESULTS: While many traditionally learn and perform direct transpsoas fusions through left-sided approaches, it is essential to consider pertinent anatomical features or variations, surgical pathologies, and patient-specific symptoms. The optimal side of the approach may vary based on these factors and remain key considerations for a holistic decision. CONCLUSIONS: A thoughtful assessment of the factors highlighted here can significantly improve the likelihood of a successful prone or lateral transpsoas fusions. Although comprehensive studies are needed to better guide decisions between right- and left-sided approaches, surgeons currently rely on their clinical judgment and expertise to navigate these choices to maximize safety and efficacy for each patient. CLINICAL RELEVANCE: This study highlights minimizing surgical risk through holistic patient-centered decision-making.

Source: The International Journal of Spine Surgery

DOI: 10.14444/8721

Authors: Brian Owler, Vijidha Shree Rajkumar, Yi Yuen Wang

Institutions: Australian National University, Sydney Adventist Hospital, The University of Melbourne, St Vincent's Hospital Melbourne

Language: English

Topic: Spine and Intervertebral Disc Pathology

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4408244497

FWCI: 0.598

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Cited by: 1

Related to: 10