Sagittal plane optimization with prone transpsoas lateral interbody fusion (PTP LIF)

Abstract

Prone Transpsoas Lateral Interbody Fusion (PTP LIF) represents a natural evolution of lateral decubitus LIF by producing enhanced lordosis associated with the familiar prone position. Techniques such as anterior docking, anterior column realignment (ACR), screws first spondylolisthesis reduction, and anterior placement of large, expandable cages allow the surgeon to maximize sagittal correction when appropriate. Caution must be taken not to create too much lordosis in upper lumbar levels, especially in patients with low pelvic incidence. As sagittal alignment targets have evolved from global to regional and now segmental, the versatility of PTP LIF will allow surgeons to achieve level specific reconstructions with more precision and less invasiveness for the betterment of patient outcomes.