Background Lateral lumbar interbody fusion has proven effective for various spinal pathologies, and ambulatory surgery centers (ASCs) offer cost-effective alternatives to hospital settings. However, no reports exist regarding single-position lateral interbody fusions with posterior pedicle screw instrumentation performed at ASCs. The primary research question was whether single-position extreme lateral interbody fusion (XLIF) with posterior pedicle screw instrumentation can be safely performed in an ASC setting. Methods A retrospective review was conducted on 22 patients who underwent single-level, single-position XLIF with posterior pedicle screw instrumentation at a free-standing ASC without overnight-stay capabilities. Data on operative time, intraoperative complications, length of stay, hospital admissions, and return to the operating room within 6 months were collected and analyzed. Radiographic measurements were performed pre- and postoperatively. Results All cases were completed in less than 2 hours with a mean length of stay of 142 minutes (maximum, 220 minutes). No patients required hospital admission or overnight stay. There were no returns to the operating room within 6 months postoperatively. One patient (4.5%) experienced transient hip flexor weakness with no permanent neurological complications. Radiographic analysis showed a significant increase in disc height at the operative level (from 7.3 mm to 12.2 mm, P Conclusions This case series demonstrates the feasibility and favorable early safety profile of single-position XLIF with posterior pedicle screw instrumentation performed in an ASC setting for appropriately selected patients. The procedure is associated with short operative times, minimal complications, and no need for hospital admission or early reoperation. Further studies with larger sample sizes and longer follow-up periods are warranted to confirm these findings and evaluate long-term outcomes. Clinical Relevance This study demonstrates the feasibility of performing single-position XLIF with posterior pedicle screw instrumentation in ASC settings, potentially reducing health care costs while maintaining safety and efficacy. Level of Evidence 4.
Salazar et al. (Thu,) studied this question.