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Research ArticleMinimally Invasive Surgery

Prone Lateral Transpsoas Approach to the Spine: A Technical Guide for Mastery

Juan P. Giraldo, Winward Choy and Juan S. Uribe
International Journal of Spine Surgery February 2025, 19 (S1) S19-S27; DOI: https://doi.org/10.14444/8712
Juan P. Giraldo
1 Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
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Winward Choy
1 Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
MD
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Juan S. Uribe
1 Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
MD
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  • For correspondence: Neuropub@barrowneuro.org
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    Figure 1

    Ergonomics of the prone lateral transpsoas approach during percutaneous pedicle screw fixation and lateral lumbar fusion.2–4 Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

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    Figure 2

    Senior author’s recommendations and advantages of the prone lateral transpsoas approach vs lateral lumbar interbody fusion. Used with permission from Barrow Neurological Institute, Phoenix, Arizona. Abbreviations: MIS, minimally invasive surgery; Nav, navigation.

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    Figure 3

    Standing radiographs using the electro-optical system (EOSedge, ATEC Spine Group) for preoperative spinal alignment and surgical planning. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

  • Figure 4
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    Figure 4

    Patient positioning for prone lateral transpsoas approach. (A) Lateral view during prone lateral positioning. (B) View from above prone lateral positioning with bedside breaking for surgical approach. The participants and all identifiable individuals consented to the publication of their images. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

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    Figure 5

    Operative steps. (A) The patient is placed in the prone position, and the surgeon is seated. (B) The initial dilator is placed. (C) Sequential dilation is performed. (D) A retractor is placed over the dilator. (E) The disc space is visualized, and a discectomy is performed. (F) The interbody cage is placed after discectomy and endplate preparation. (G) Pedicle screws are placed using computed tomographic navigation and robotic assistance. The participants and all identifiable individuals consented to the publication of their images. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

  • Figure 6
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    Figure 6

    Illustration exemplifying intraoperative monitoring and retractor positioning for the prone transpsoas approach. (A) The initial dilator is placed. (B) Sequential dilation is performed. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

  • Figure 7
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    Figure 7

    Postoperative (A) coronal and (B) sagittal standing radiographs after the prone transpsoas approach for previous lumbar fusion extension. The participants and all identifiable individuals consented to the publication of their images. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

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International Journal of Spine Surgery: 19 (S1)
International Journal of Spine Surgery
Vol. 19, Issue S1
1 Feb 2025
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Prone Lateral Transpsoas Approach to the Spine: A Technical Guide for Mastery
Juan P. Giraldo, Winward Choy, Juan S. Uribe
International Journal of Spine Surgery Feb 2025, 19 (S1) S19-S27; DOI: 10.14444/8712

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Prone Lateral Transpsoas Approach to the Spine: A Technical Guide for Mastery
Juan P. Giraldo, Winward Choy, Juan S. Uribe
International Journal of Spine Surgery Feb 2025, 19 (S1) S19-S27; DOI: 10.14444/8712
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  • Article
    • Abstract
    • Introduction
    • Preoperative Planning and Surgical Methodology
    • Patient Positioning
    • Results
    • Discussion
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    • Acknowledgments
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More in this TOC Section

  • Key Considerations in Surgical Decision-Making on the Side of Approach for Lumbar Lateral Transpsoas Interbody Fusion Techniques
  • Comparative Review of Lateral and Oblique Lumbar Interbody Fusion: Technique, Outcomes, and Complications
  • A Spine Surgeon’s Learning Curve With the Minimally Invasive L5 to S1 Lateral ALIF Surgical Approach: Perioperative Outcomes and Technical Considerations
Show more Minimally Invasive Surgery

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Keywords

  • lateral
  • lateral lumbar interbody fusion
  • lumbar
  • minimally invasive surgery
  • patient positioning
  • prone
  • prone transpsoas
  • spine
  • surgery

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