Single position lateral lumbar interbody fusion with navigated percutaneous pedicle screw fixation: technique modification with resultant resource usage optimisation.

Abstract

Background: There is an increase in the volume of elective lumbar fusion surgeries. Various techniques have been described however the literature on cost comparisons of different fusion techniques is sparse. The aim of this study was to evaluate resource utilisation of single position (SP) lateral lumbar interbody fusion (LLIF) compared to dual position (DP) LLIF.

Methods: This retrospective study included all patients who underwent single-stage anterior to psoas (ATP) LLIF with navigated percutaneous pedicle screw (PPS) fixation by the senior author between September 2020 and September 2023. Demographic details, operative variables (duration of surgery, SP/DP) and complications (intra-operative, post-operative) were included. Variables related to resource usage included length of stay, implant fee, consumables fee, anaesthetist fee and facility fee.

Results: There were 6 patients in the SP group and 14 patients in the DP group. None of the patients had intra-operative complications. SP group was associated with a 44.6% decrease in the length of stay (P=0.023) compared to the DP group, holding CCI and levels constant. The median operative time for the SP and DP groups were 150 and 282.5 min respectively (P<0.001). The median consumables fee ($2,509 vs. $3,839, P<0.001) for the SP group were lower than the DP group.

Conclusions: SP LLIF with navigated PPS insertion described in this paper is a minimally invasive technique with reduced resource usage compared to DP LLIF.