Comparison of standard and modified prone positioning for lateral lumbar spine fusion: a feasibility study to reduce lumbar plexus injury
8
Issued Date
2023-12-25
Resource Type
ISSN
2414469X
eISSN
24144630
Scopus ID
2-s2.0-85186446931
Journal Title
Journal of Spine Surgery
Volume
9
Issue
4
Start Page
463
End Page
471
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Spine Surgery Vol.9 No.4 (2023) , 463-471
Suggested Citation
Chumnanvej S., Lekcharoensombat N. Comparison of standard and modified prone positioning for lateral lumbar spine fusion: a feasibility study to reduce lumbar plexus injury. Journal of Spine Surgery Vol.9 No.4 (2023) , 463-471. 471. doi:10.21037/jss-23-92 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/97580
Title
Comparison of standard and modified prone positioning for lateral lumbar spine fusion: a feasibility study to reduce lumbar plexus injury
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Abstract
Single-prone-lateral (PL) positioning is a new technique that allows for simultaneous anterior and posterior lumbar spine surgery. However, there is a concern regarding the risk of lumbar plexus injury in PL positioning. This study compared the risk of lumbar plexus damage and the overall safety profile of a modified PL (mPL) position to the standard PL (sPL) position for lateral lumbar spine fusion surgery. A crossover soft cadaveric study was conducted with two raters examining the comparative outcomes of position A: sPL and position B: mPL. The mPL position differs from the sPL position in that the ipsilateral arm is placed at the side of the body rather than above the head. To assess positive results (no lumbar plexus injury) between positions A and B, a mixed effects logistic regression model was utilized. The odds ratio of a good result between positions B and A was also determined. The odds ratio of the favorable outcome between position B and A was 1.77, indicating significantly higher odds of a favorable outcome in the modified position B than in the control or position A. The mPL positioning outperformed the sPL positioning in terms of safety and efficacy for lateral lumbar spine fusion. The mPL positioning may reduce the risk of lumbar plexus injury by allowing for a more direct approach to the lumbar spine and by avoiding excessive stretching of the lumbar plexus.