Early Thigh Symptoms After Lateral Lumbar Interbody Fusion
Abstract: Background: Ipsilateral thigh pain, altered sensation, and hip flexion weakness are common after transpsoas lateral lumbar interbody fusion (LLIF). A much smaller group has a clinically important femoral or lumbar plexus injury. Early triage requires a reproducible examination and attention to changing symptoms rather than a single label of approach-related neuropraxia. Methods: This focused narrative review examines primary cohorts published through September 2026, including longitudinal motor assessments, a recent 545-patient neurological complication series, a multicenter retractor-time study, and a report of postoperative psoas hematoma. It separates symptoms, strength grades, anatomy, and time points; it is not a systematic review or pooled incidence estimate. Results: In a recent 1,000-patient stand-alone LLIF series, 17.2% of the later-era cohort had at least one grade of iliopsoas and/or quadriceps loss at discharge; 74% of affected patients recovered fully by six weeks and 97.1% by one year. L4/5 involvement and longer operative time predicted weakness at six weeks. A separate 545-patient series reported acute thigh paraesthesia in 14.4%, transient motor weakness in 13.2%, femoral palsy in 1.3%, and psoas hematoma in 1.4%. Rates vary markedly with definitions and ascertainment. A multicenter study found that retraction beyond 20 minutes did not reliably identify quadriceps palsy. Conclusion: Mild, nonprogressive approach-side sensory change or hip flexion discomfort can be followed with a documented serial examination. New or worsening quadriceps weakness, knee buckling, severe or expanding pain, contralateral symptoms, falling hemoglobin, or hemodynamic change calls for prompt assessment and imaging tailored to the suspected neural, implant, or retroperitoneal cause. The published cohorts describe prognosis; they have not validated a rigid observation or imaging algorithm.
Keywords: lateral lumbar interbody fusion; thigh pain; lumbar plexus; femoral neuropathy; hip flexor weakness; psoas hematoma
How to Cite?: Nishant, "Early Thigh Symptoms After Lateral Lumbar Interbody Fusion", Volume 15 Issue 10, October 2026, International Journal of Science and Research (IJSR), Pages: 229-231, https://www.ijsr.net/getabstract.php?paperid=SR261002182603, DOI: https://dx.doi.org/10.21275/SR261002182603