Table Rotation Technique to Access the L4-5 Disc Space in the Prone Transpsoas Approach: A Technical Note

Study DesignRetrospective analysis and case series.ObjectivesThis study evaluates the differences in electromyography (EMG) recordings when using a novel table rotation technique for the placement of dilators and retractors compared to the standard technique for a prone transpsoas (PTP) lateral lumbar interbody fusion at L4-5.MethodsTen patients underwent single-level PTP surgery at L4-5, with EMG recordings anteriorly and posteriorly on top of the psoas muscle and at the disc space. EMG recordings were evaluated with the bed in a neutral position and again after the operating table was rotated 30° away from the surgeon.ResultsAll 10 patients had significantly improved EMG values at all points after table rotation. Before table rotation, the posterior EMG values were in the risk zone (