Fully Navigated Single-Position Prone Lateral Lumbar Interbody Fusion: A Detailed Technical Report and Description of 15 Cases

<h3>Background</h3> Navigation increases the precision and safety of pedicle screw placement and has been used to place interbody cages for lateral lumbar interbody fusion. Single-position surgery shortens its duration and that of anesthesia. The aim of this study was the feasibility of simultaneous cage and screw placement in a single prone position using intraoperative navigation without the need for additional fluoroscopy and a detailed technical description of this procedure. <h3>Methods</h3> We retrospectively analyzed 15 patients who underwent simultaneous navigated lateral lumbar interbody fusion and posterior instrumentation in a single prone position. A detailed technical description of the procedure is provided. Surgery duration, blood loss, complications, and radiographic parameters were recorded. <h3>Results</h3> A total of 24 cages were placed in 15 patients. The mean time taken for cage placement was 21 ± 6.70 minutes, and there were no major complications. Mean surgery duration and blood loss per case, including posterior instrumentation, were 263 ± 94 minutes and 315 ± 143 mL, respectively. There were significant improvements in pre- to postoperative Oswestry Disability Index scores (51.38 ± 15.93 vs 32.81 ± 17.18, <i>P</i> &lt; 0.001) and segmental lordosis (3.26° ± 8.97° vs 13.09° ± 15.25°, <i>P</i> &lt; 0.001). <h3>Conclusion</h3> The present study’s results showed the feasibility of lateral lumbar interbody fusion using simultaneous posterior pedicle screw instrumentation and intraoperative navigation in a single prone position. <h3>Clinical Relevance</h3> Navigated lateral lumbar interbody fusion and posterior instrumentation in a single prone position possibly reduces operating time and blood loss and reduces exposure of operation room personnel to radiation. <h3>Level of Evidence</h3> 4.