Procedural Checklist for Retroperitoneal Transpsoas Minimally Invasive Lateral Interbody Fusion.

Abstract

An expert opinion. The aim of this study is to provide an overview of the surgical technique with an emphasis on complication avoidance techniques and to present a procedural checklist for the retroperitoneal transpsoas minimally invasive lateral approach. Although the minimally invasive lateral interbody fusion has gained popularity in the past decade, complication rate variability remains in the literature, driven by inconsistent adherence to technique, neuromonitoring, and complication avoidance techniques. The surgical and complication avoidance techniques for extreme lateral interbody fusion are presented in a stepwise fashion from the practice of an experienced lateral approach surgeon. The technical description and procedural checklist cover preoperative assessment, operating room setup, patient positioning, surgical procedure, and postoperative evaluation. A systematic approach through preoperative assessment, attention to surgical technique and intraoperative neuromonitoring, and a detailed postoperative evaluation are key to achieving the goal of lateral interbody fusion with minimization of procedural morbidity. 5.