From adoption to optimization: A 5-year analysis of efficiency in single-position prone lateral lumbar interbody fusion at L4–5

Abstract

This five-year retrospective study examined operative efficiency in 107 single-level L4–5 prone lateral lumbar interbody fusion (pLLIF) cases within a 324-patient series. Operative time declined 70 %, from 161 min in 2019 to 48 min in 2024, with progressive narrowing of interquartile ranges. No femoral nerve injuries occurred in the single-level cohort, and complications were infrequent, limited to the early learning phase. Contributing factors included improved fluoroscopic coordination, retractor control, and team cohesion. These findings may provide surgeons adopting the technique an idea of the efficiency gains that can be expected with growing experience.