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28.01.2020 | Ideas and Technical Innovations | Sonderheft 1/2020 Open Access

European Spine Journal 1/2020

Prone single-position extreme lateral interbody fusion (Pro-XLIF): preliminary results

European Spine Journal > Sonderheft 1/2020
Claudio Lamartina, Pedro Berjano
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-020-06303-z) contains supplementary material, which is available to authorized users.
The study was partially funded by a grant from the Society of Lateral Access Surgery (SOLAS) and funds from the Italian Ministry of Health.

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Single-position options for combined anterior and posterior fusion in the lumbar spine have been suggested to reduce the surgical time and improve the efficiency of operating room. Previous reports have focused on lateral decubitus single-position surgery. The goal of this study is to describe and evaluate the feasibility and safety of prone single-position extreme lateral interbody fusion (XLIF) with posterior fixation.


Design Pilot prospective non-randomized controlled study. Seven patients who underwent prone single-position XLIF and posterior fixation were evaluated (Pro-XLIF). A control group (Std-XLIF) was composed of ten patients who underwent XLIF in lateral decubitus and posterior fixation in prone position. All patients underwent interbody XLIF fusion at one level and posterior procedures at one or more levels. Duration of surgery, blood loss, complications, X-ray use and clinical outcomes were recorded.


No major complications were observed in either group. Oswestry Disability Index, back pain and leg pain were improved in the Pro-XLIF group from 48.5, 7.7 and 8.5 to 14.5, 1.71 and 2.71, respectively, and in the Std-XLIF group from 50.8, 5.7 and 7.2 to 22.5, 3.7 and 2.5. The Pro-XLIF group had a longer time of preparation before incision (39 vs 26 min, ns), equal duration of the anterior procedure (65 vs 59 min, ns), shorter duration of surgery (133 vs 182 min, ns) and longer X-ray exposure time (102 vs 92 s, ns). The surgical technique is described.


Prone single-position XLIF is feasible and safe. In this preliminary report, the results are comparable to the standard technique.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

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