Clinical Outcomes of Prone Transpsoas Lumbar Interbody Fusion: A 1-Year Follow-Up

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Figure 1
Function Global Rating of Change (GROC) postoperative scores at 2 wk, 6 wk, 3 mo, and 1 y.
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Figure 2
Pain Global Rating of Change (GROC) postoperative scores at 2 wk, 6 wk, 6 mo, and 1 y.
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Figure 3
Patient-acceptable symptom state (PASS) postoperative scores at 2 wk, 6 wk, 6 mo, and 1 y.

Table 1

Demographics of study participants.

Characteristics	n (%)
No. of patients	97
No. of levels	161
No. of PTP levels
1	55 (57)
2	29 (30)
3	6 (6)
4	7 (7)
No. of PTP levels
2	29 (30)
3	6 (6)
4	7 (7)
Total No. of levels fused
1	40 (41)
2	25 (26)
3	15 (16)
4	15 (16)
5+	2 (2)
Level of PTP
L1−L2	18 (11)
L2−L3	34 (21)
L3−L4	53 (33)
L4−L5	56 (35)
No. of transforaminal lumbar interbody fusion levels
0	76 (79)
1	15 (16)
2	5 (5)
3	1 (1)
No. of anterior lumbar interbody fusion levels
0	94 (97)
1	2 (2)
2	1 (1)
Gender, female	54 (56)
Age, y, mean (SD)	62 (11)
Body mass index, mean (SD)	30 (7)
Comorbidities
Hypertension	69 (71)
Hyperlipidemia	42 (43)
Diabetes	18 (19)
Coronary artery disease	9 (9)
Congestive heart failure	1 (1)
Chronic obstructive pulmonary disease	11 (11)
Chronic kidney disease	6 (6)
ASA classification
1	2 (2)
2	58 (60)
3	37 (37)

Table 2

Mean (SD) change in radiographic parameters.

Radiographic Measurement	N	Mean (SD) Change Compared With Preoperation	P
LL (°)	95
Initial postoperative		2 (10)	0.049
1 y postoperative		3 (9)	0.005
SL (°)	155
Initial postoperative		6 (5)	<0.001
1 y postoperative		5 (5)	<0.001
ADH (mm)	155
Initial postoperative		8 (4)	<0.001
1 y postoperative		7 (4)	<0.001
PDH (mm)	155
Initial postoperative		3 (2)	< 0.001
1 y postoperative		3 (2)	< 0.001

Abbreviations: ADH, anterior disc height; LL, lumbar lordosis; PDH, posterior disc height; SL, segmental lordosis.

Table 3

Mean (SD) change in patient-reported outcomes.

Patient-Reported Outcomes	n	Mean (SD) Change Compared With Preoperation	P
ODI
2 wk	41	3.7 (22.8)	0.307
6 wk	48	−8.7 (18.3)	0.002
6 mo	45	−24.2 (15.1)	<0.001
1 y	42	−21.7 (19.6)	<0.001
Pain EQ5D
2 wk	43	0.00 (0.21)	0.9
6 wk	51	0.12 (0.2)	<0.001
6 mo	47	0.17 (0.2)	<0.001
1 y	45	0.19 (0.3)	<0.001
Leg VAS
2 wk	48	−2.6 (3.9)	<0.001
6 wk	52	−3.5 (3.5)	<0.001
6 mo	48	−4.6 (2.7)	<0.001
1 y	46	−4.4 (3.6)	<0.001
Back VAS
2 wk	48	−1.7 (2.8)	<0.001
6 wk	52	−3.5 (2.7)	<0.001
6 mo	48	−4.3 (2.3)	<0.001
1 y	46	−4.2 (2.6)	<0.001

Table 4

Postoperative complications of study participants.

Complication	n (%)
Intraoperative complications
ALL rupture	8 (8)
Aborted prone transpsoas level	2 (2)
Postoperative neuromotor complications
Ipsilateral hip flexor pain	45 (46)
Ipsilateral hip flexor weakness	57 (59)
Ipsilateral thigh numbness	23 (24)
Contralateral hip flexor pain	28 (29)
Contralateral hip flexor weakness	21 (22)
Femoral nerve palsy	2 (2)
Postoperative medical complications
Urinary retention	8 (8)
Deep vein thrombosis	1 (1)
Pneumonia	1 (1)
Altered mental status	5 (5)
Urosepsis	3 (3)
Death	2 (2)
Other complications
Abdominal wall pseudohernia	1 (1)
Subsidence on 1-y radiographs	6 (6)