Avoiding lumbar segmental arteries injury in oblique lateral interbody fusion procedure

Lumbar interbody fusion is performed to treat several spinal disorders and involves the insertion of a structural graft into an intervertebral disk space to promote bony arthrodesis. Although the posterior approach to the lumbar spine was long the most frequently adopted surgical strategy to perform fusion, anterior approaches, first introduced in 1906, have recently blossomed. Patient expectations and increasing demands for shorter hospital stay and early recovery have led to more innovative surgical techniques to reduce iatrogenic injury and postoperative morbidity. Depending on the level to be treated, several approaches have been developed, each dealing with peculiar anatomic obstacles: pure anterior, oblique anterior or lateral, and transpsoas or prepsoas. These operations can be performed using miniopen or minimally invasive approaches without clear definitive evidence for approach being superior to another in terms of fusion or clinical outcomes.