A new approach to spinal fusion comes with significant advantages over the traditional open method, according to Themistocles Protopsaltis, MD, chief of spine surgery and co-director of the Spine Center at NYU Langone in New York City.
Single-position anterior–posterior lumbar fusion surgery places patients on their side for the entire procedure instead of repositioning them from their back or side to their stomach during surgery.
"We can achieve better height restoration, especially for slipped disks where the vertebrae shift out of position," Dr. Protopsaltis said in a Dec. 8 news release. "It gives us more powerful anatomical control to restore disks to their normal alignment — which is more likely to heal and eliminate problems patients can experience later due to segment degeneration."
The approach facilitates the placement of larger cages along the weight-bearing cortical bone to offer improved structural support, which is ideal for patients with poor bone quality, Dr. Protopsaltis said
But the single-position technique often requires a multidisciplinary approach to surgery.
A vascular surgeon typically performs the anterior approach through the lower abdomen or a lateral incision, parting the hip flexor muscles and reaching the target. The spine surgeon then removes the disc and reconstructs the vertebral column.
In a November study in The Spine Journal, researchers found the technique led to reduced blood loss, less postoperative intestinal blockage and shorter OR times, compared to traditional spinal fusion.