Medical Student Duke University School of Medicine Durham, NC, US
Disclosure(s):
Alyssa M. Bartlett, MPH: No financial relationships to disclose
Introduction: Lateral spine surgery techniques have become a popular choice in the treatment of spine deformity due to its minimally invasive approach and ability to achieve significant deformity correction. for deformity correction. Yet, combining these with anterior and posterior approaches often necessitates repositioning patients during surgery, leading to inefficiencies and higher costs. However, the relatively novel prone lateral technique offers an alternative that may enhance surgical efficiency and outcomes. This study aims to compare the clinical and radiographic outcomes of these two techniques in the management of adult spinal deformity.
Methods: We conducted a retrospective review of patients undergoing spine deformity correction using the lateral (n=31) or prone lateral (n=94) approach across 11 institutions. Deformity was defined as preoperative sagittal vertical axis (SVA) > 5cm or pelvic incidence to lumbar lordosis (PI-LL) mismatch > 10. Analyses encompassed demographic, perioperative, spinopelvic parameters, and patient-reported outcomes measures data.
Results: Findings indicated that both lateral and prone lateral approaches result in significant improvement in lumbar lordosis (p < 0.0001 for both groups) and segmental lordosis (p=0.008 vs p=0.005 for lateral and prone lateral, respectively). However, only the prone lateral technique showed significant improvement in pelvic tilt (p < 0.0001) and PI-LL mismatch (p < 0.0001). Average preoperative Visual Analog Scale (VAS) scores significantly improved for patients undergoing surgery from both techniques (p < 0.0001 for both groups).
Conclusion : Although lateral surgery has been the mainstay for surgical spine deformity correction and demonstrates similar improvements in pain, the prone lateral approach represents effective deformity correction that meets or may exceed this approach with significant improvements in spinopelvic parameters.
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