Hanyang Med Rev.  2008 Feb;28(1):70-76.

Minimally invasive anterior approach to the lumbar spine

Affiliations
  • 1Department of Neurosurgery, School of Medicine, Hanyang University, Seoul, Korea. pkh2325@hanyang.ac.kr

Abstract

A technique and clinical experiences of minimally invasive anterior lumbar interbody fusion ( mini-ALIF ) are reported. Despite its biomechanical advantages and high fusion rate, conventional ALIF needs a long skin incision and extensive dissection. Endoscopic approaches for ALIF seem to be associated with considerable technical difficulties, long operation time, and high complication rate even in collaboration with a laparoscopic surgeon. Mini-ALIF involves a standardized minimally invasive microsurgical retroperitoneal approach for L2-3 to L4-5, and transperitoneal approach for L5-S1. Mini-ALIF can be done through minimal skin incision(4-5cm) and blunt muscle dissection without abdominal muscle cutting. The surgical indications are degenerative disc diseases, disc herniations, degenerative spondylolisthesis, and iatrogenic postoperative instability including postoperative pseudarthrosis. Lumbar artificial disc replacement is a new indication to this technoque. Mini-ALIF provided sufficient operation space for lumbar interbody fusion. Consequently, operation time, bleeding, and postoperative morbidity of ALIF could be reduced.

Keyword

Minimally invasive spine surgery; Anterior lumbar interbody fusion; Spinal fusion; Lumbar spine; Microsurgery
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