Objective To explore the feasibility and clinical efficacy of prone transpsoas lateral interbody fusion(PTP LIF)combined with posterior pedicle screw fixation for the treatment of lumbar degenerative diseases in the prone position.Methods A total of 23 patients who underwent LLIF in the prone position at the First People's Hospital of Yunnan Province be-tween March 2023 and October 2023 were retrospectively analyzed.The cohort comprised 9 males and 14 females,with a mean age of 55.5±8.8 years(range,41-70 years).The clinical diagnoses included intervertebral disc herniation with endplate inflamma-tion(3 cases),lumbar spinal stenosis(13 cases),lumbar spondylolisthesis(5 cases),and lumbar instability(2 cases).The surgical segments involved L3,4(15 cases),L4,5(6 cases),and L3-L5(2 cases),with 21 cases involving a single segment and 2 cases involv-ing double segments.The disc height and lumbar lordosis Angle before and after surgery were compared.Lower back pain was evaluated using the visual analogue scale(VAS),while lumbar spine function was assessed via the Oswestry Disability Index(ODI).Clinical efficacy was evaluated according to the modified MacNab criteria at the last follow-up.Results All surgeries were successfully completed.The operation time was 120.2±21.4 min(range,90-175 min),intraoperative blood loss was 131.1±40.8 ml(range,60-200 ml),and the hospital stay was 6.2±1.6 days(range,4-10 days).Follow-up was obtained for all 23 cases,with the follow-up time being 9.6±2.2 months(range,6-13 months).One case of endplate damage occurred during surgery,two cases of transient psoas muscle weakness occurred postoperatively,and one case of lowcr limb pain and numbness was reported;no cases of wound infection or delayed healing were observed.The postoperative disc height improved compared to preoperative(6.8±1.9 mm;F=66.618,P＜0.001).There was no statistically significant difference between 3 months postoperative(11.1±1.2 mm)and im-mediately postoperative(12.2±1.2 mm;P＞0.05),but there was a statistically significant difference between the last follow-up(10.7±1.1 mm)and immediately postoperative(P＜0.05).The postoperative lumbar lordosis angle improved compared to preopera-tive(35.3°±5.4°;F=19.465,P＜0.001),with no statistically significant difference between 3 months postoperative(44.1°±5.4°)and immediately postoperative(47.8°±6.6°;P＞0.05),but there was a statistically significant difference between the last follow-up(43.2°±5.3°)and immediately postoperative(P＜0.05).The postoperative VAS score improved compared to preoperative(6.3±1.1 points;F=79.931,P＜0.001),and the last follow-up(1.1±1.1 points)showed further improvement compared to 3 months postopera-tive(1.7±1.4 points;P＜0.05).The postoperative ODI improved compared to preoperative(69.9％±7.4％;F=592.392,P＜0.001),with 3 months postoperative(23.1％±3.1％)showing improvement compared to 1 month postoperative(29.2％±3.1％),and the last follow-up(17.5％±3.6％)showing further improvement compared to 3 months postoperative(P＜0.05).At the last follow-up,the modified MacNab criteria were:excellent in 16 cases,good in 5,fair in 2,with an excellent and good rate of 91％(21/23);7 cases of cage subsidence were observed,with no cases of internal fixation loosening.Conclusion PTP LIF combined with pedicle screw fixation for the treatment of lumbar degenerative diseases is safe and effective,with satisfactory short-term postoperative outcomes.
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