Camera-assisted and navigated single-position prone transpsoas lateral lumbar interbody fusion: illustrative case.

Abstract

Background: Single-position prone transpsoas lateral lumbar interbody fusion (PTP-LLIF) is an evolving minimally invasive surgery technique that merges the biomechanical and anatomical advantages of prone positioning with the LLIF approach. While PTP-LLIF enhances lumbar lordosis restoration and operative efficiency by eliminating patient repositioning, it presents unique ergonomic and visualization challenges for surgeons. This technical report describes a novel modification of the technique using the Teligen camera to improve intraoperative visualization and reduce surgeon fatigue.

Observations: The approach follows standard PTP-LLIF workflow with modifications allowing the use of retractor-mounted optical cameras and integrated navigation. The system enables real-time visualization of disc preparation and cage placement while minimizing reliance on repeated fluoroscopic imaging.

Lessons: Integration of the Teligen system improves ergonomic posture for the surgeon, reduces the frequency of radiation exposure, and provides continuous visual access for both the lead surgeon and the operative team. Enhanced intraoperative efficiency and teaching opportunities are also noted. The Teligen camera-assisted technique offers a promising enhancement to PTP-LLIF by improving surgeon ergonomics and visualization without compromising procedural effectiveness. Early clinical experience suggests potential reductions in radiation exposure and operative time. Future comparative studies are warranted to validate these findings and establish long-term outcomes. https://thejns.org/doi/10.3171/CASE25418.