Single-Position Surgery versus Lateral-Then-Prone-Position Circumferential Lumbar Interbody Fusion: A Systematic Literature Review

Abstract

Objective: We sought to compare the outcomes of single-position (SP) circumferential lumbar interbody fusion in lateral decubitus versus dual-position (DP) fusion.

Methods: A systematic literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in PubMed, Web of Science, and Scopus databases to identify comparative studies reporting the outcomes of SP lumbar interbody fusion versus DP. For risk of bias assessment, the ROBINS-I (risk of bias in nonrandomized studies of interventions) tool was used.

Results: Four comparative studies were included from an initial search of 3780 papers. All 4 studies were retrospective cohort studies comparing outcomes of SP versus DP LLIF. A total of 349 patients were operated using SP versus 254 using DP. All studies involved reported operating time, estimated blood loss, length of stay, change in segmental lordosis, and complications. From a general perspective, baseline variables were similar in both groups in all the studies and all reported a significant decrease in operative time and length of stays with SP.

Conclusions: Literature comparing SP versus lateral-then-prone lumbar fusion shows a tendency toward shorter operating time and hospital stays in SP lumbar fusion while maintaining similar perioperative outcomes.

Keywords: Dual-position spine; Flip spine; Lateral lumbar interbody fusion; Lumbar fusion; Single-position spine.