ArticleInternational journal of spine surgery2026
Side of Approach Does Not Affect Outcomes in Direct Lateral Lumbar Interbody Fusion: A Noninferiority Retrospective Cohort Study.
Article in International journal of spine surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLateral lumbar interbody fusion (LLIF) is a minimally invasive surgical technique with various clinical benefits. However, there is no consensus on the optimal side of approach. This study investigates clinical and radiographic outcomes associated with surgical laterality, where the approach side was chosen based on operating room theater flow rather than anatomy.
methodsRetrospective analysis of prospectively collected data from 233 patients (2016-2021) who underwent LLIF by 2 surgeons, each consistently using a specific side according to operating room setup. Outcomes included the Oswestry Disability Index, visual analog scale, 12-Item Short Form Health Survey, and radiographic fusion. Statistical comparisons included predefined noninferiority margins for operative time (15 minutes) and fusion (10%).
resultsLeft-sided (
conclusionsLLIF outcomes did not differ by side of approach. While anatomical considerations may apply in selected cases (eg, coronal deformity), theater flow factors can guide side selection without compromising outcomes. This study is limited by surgeon-side bias and the absence of randomization. CLINICAL RELEVANCE: This study demonstrates that when performing LLIF, the side of approach (left vs right) does not significantly affect operative time, fusion rates, complication rates, or patient-reported outcomes when chosen based on operating room theater flow rather than patient anatomy. These findings suggest that surgeons may prioritize ergonomic efficiency and operating room logistics without compromising clinical or radiographic results, except in specific cases such as significant coronal deformity or prior retroperitoneal surgery. LEVEL OF EVIDENCE: Level 3.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.