Lateral lumbar spine surgery: Fixation considerations

Abstract

Lateral approaches to the lumbar spine offer an alternative technique for addressing numerous diseases of the lumbar spine. The retroperitoneal approach provides a surgical corridor that affords the use of large interbody footprints while maintaining the stabilizing ligaments of the anterior and posterior spinal columns and mitigating the need for mobilization of the great vessels associated with an anterior approach. While the literature highlights clinical scenarios whereby standalone lateral interbody devices may be used, supplemental fixation is often warranted. Supplemental fixation strategies include integrated interbody or supplemental lateral plate fixation, interspinous process fixation, facet screw, or pedicle screw fixation.