24. Lateral decubitus single position circumferential fusion (ALIF & PSF) improves perioperative outcomes compared to traditional anterior-posterior fusion

BACKGROUND CONTEXT Lateral decubitus single position anterior-posterior (AP) fusion utilizing anterior lumbar interbody fusion and percutaneous posterior fixation (SPS) is a novel, Minimally Invasive Surgical technique. Single position AP fusion with anterior or lateral interbodies has been shown to be a safe, effective technique to treat of lumbar degenerative disease. This study directly compares perioperative outcomes of SPS vs FLIP for degenerative pathologies. PURPOSE To determine if SPS with lateral ALIF (LALIF) improves perioperative outcomes compared to FLIP patients. STUDY DESIGN/SETTING Multicenter retrospective cohort study. PATIENT SAMPLE A total of 321 patients undergoing primary AP fusions with ALIF and bilateral percutaneous pedicle screw fixation at 5 institutions from 2015 to 2020. OUTCOME MEASURES Levels fused, inclusion of L4-L5, L5-S1, radiation dosage, operative time, estimated blood loss (EBL), length of stay (LOS), perioperative complications and radiographic outcomes. METHODS Retrospective analysis of primary ALIFs with bilateral percutaneous pedicle screw fixation between L4-S1 over 5 years at 5 institutions. Patients were grouped as FLIP or SPS. Outcome measures: levels fused, inclusion of L4-L5, L5-S1, radiation dosage, operative time, estimated blood loss (EBL), length of stay (LOS), perioperative complications. Radiographic analysis included lumbar lordosis (LL), pelvic incidence (PI), and PI-LL mismatch. Measures were compared using independent samples t-tests and chi-squared analyses, significance set at p RESULTS A total of 321 patients: 124 SPS, 197 Flip were identified. PSM was performed due to differences between groups in levels fused, and proportion involving L4-5, yielding 248 patients: 124 SPS, 124 FLIP. The SPS cohort demonstrated significantly reduced OpTime (132.95±77.45 vs 261.79±91.65 min; p CONCLUSIONS Single position lateral ALIF with percutaneous posterior fixation improves operative efficiency, EBL, LOS, rate of ileus and maintains safety compared to supine ALIF with prone percutaneous pedicle screws between L4-S1. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.