Lateral Interbody Fusion: Indications and Techniques

There has been a universal trend across surgical specialties to minimize trauma to adjacent tissues while addressing the relevant pathology. Advances in lighting techniques, retractor technology, and magnification have fueled this trend. Within the field of spine surgery, this has manifested itself as an exponential increase in the number of minimally invasive techniques and implants available to surgeons. One of these techniques, the lateral interbody fusion has garnered considerable interest because of the small footprint it leaves in the surrounding tissues, its ability to deliver a large interbody implant through a small incision, and the surgeon's ability to avoid of the posterior elements of the spine. Initial studies have shown promising results when compared with the complications of traditional open procedures. However, certain idiosyncrasies of the lateral interbody fusion are notable: it requires meticulous patient positioning, real-time neurologic monitoring to traverse the substance of the psoas muscle, and results in some postoperative thigh symptoms in almost all patients. Despite the paucity of long-term outcome data, the indications for the lateral interbody fusion continue to evolve.