• Mohamed A R Soliman, Luis Diaz-Aguilar, Cathleen C Kuo, Alexander O Aguirre, Asham Khan, Jose E San Miguel-Ruiz, Rodrigo Amaral, Muhammad M Abd-El-Barr, Isaac L Moss, Tyler Smith, Gurvinder S Deol, Jeff Ehresman, Madison Battista, Bryan S Lee, M Craig McMains, Samuel A Joseph, David Schwartz, Andrew D Nguyen, William R Taylor, Luiz Pimenta, and John Pollina.
• Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA.
• Neurosurgery. 2023 Nov 1; 93 (5): 110611111106-1111.

Background And ObjectivesThe prone transpsoas (PTP) approach for lateral lumbar interbody fusion (LLIF) is a novel technique for degenerative lumbar spine disease. However, there is a paucity of information in the literature on the complications of this procedure, with all published data consisting of small samples. We aimed to report the intraoperative and postoperative complications of PTP in the largest study to date.MethodsA retrospective electronic medical record review was conducted at 11 centers to identify consecutive patients who underwent LLIF through the PTP approach between January 1, 2021, and December 31, 2021. The following data were collected: intraoperative characteristics (operative time, estimated blood loss [EBL], intraoperative complications [anterior longitudinal ligament (ALL) rupture, cage subsidence, vascular and visceral injuries]), postoperative complications, and hospital stay.ResultsA total of 365 patients were included in the study. Among these patients, 2.2% had ALL rupture, 0.3% had cage subsidence, 0.3% had a vascular injury, 0.3% had a ureteric injury, and no other visceral injuries were reported. Mean operative time was 226.2 ± 147.9 minutes. Mean EBL was 138.4 ± 215.6 mL. Mean hospital stay was 2.7 ± 2.2 days. Postoperative complications included new sensory symptoms-8.2%, new lower extremity weakness-5.8%, wound infection-1.4%, cage subsidence-0.8%, psoas hematoma-0.5%, small bowel obstruction and ischemia-0.3%, and 90-day readmission-1.9%.ConclusionIn this multicenter case series, the PTP approach was well tolerated and associated with a satisfactory safety profile.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.

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