Understanding femoral nerve injuries during extreme lateral lumbar interbody fusion using transabdominal muscle action potential and an event-based protocol

This study provides new insights into femoral nerve injuries incurred during XLIF, demonstrating that nerve compromise is more strongly associated with specific procedural steps rather than prolonged retractor time. TMAP monitoring, integrated with an event-based protocol, enabled real-time identification of nerve compromise, revealing that direct mechanical trauma was the primary mechanism of femoral nerve injury in XLIF.