• Hao Wu, CheungPrudence Wing HangPWHDepartment of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China., SohReuben Chee CheongRCCDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore., Jacob Yoong Leong Oh, and CheungJason Pui YinJPYDepartment of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China. Electronic address: cheungjp@hku.hk..
• Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.
• World Neurosurg. 2022 Oct 1; 166: e645e655e645-e655.

ObjectiveTo investigate the use of lateral access surgery among surgeons from the Asia-Pacific region to determine equipoise for areas of contentious use.MethodsA questionnaire was distributed to members of the Asia Pacific Spine Society. Surgeons were asked about their past experiences with lateral access surgery, including their advantages and disadvantages, specific surgical strategies, choices in implant-related factors, order of levels to operate on in multilevel reconstruction surgery, and postoperative complications.ResultsA total of 69 of 102 surgeons (67.6%) had performed lateral access surgery previously. In total, 56 participating surgeons (54.9%) agreed that anterior column reconstruction via lateral access is most of time superior to transforaminal lumbar interbody fusion and other techniques. Surgeons would consider laminectomy instead of indirect decompression in the presence of severe central or lateral recess stenosis, thickened ligamentum flavum, and facet joint hypertrophy. For the order of levels to operate on in multiple level reconstruction for deformity, where 1 stands for L3-L4 or higher, 2 stands for L4-L5, and 3 stands for L5-S1, 2-1-3 (28/95, 29.5%) was most common, followed by 1-2-3 (26/95, 27.4%), and 3-2-1 (21/95, 22.1%).ConclusionsLateral access surgery is seeing greater use in the Asia-Pacific region, especially in upper middle- to high-income countries, whereas keenness of surgeons who practice in lower middle- to low-income countries can be improved by more training, resources, and reasonable cost. A high percentage of surgeons do not consider indirect decompression for spinal stenosis. There was no consensus on the order of levels in multiple level reconstruction for deformity.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

12 keywords...

hide…