The role of anterior interbody fusion (ALIF and XLIF with anterior column release) in the surgical management of adult spinal deformity

Anterior interbody fusions are commonly used in the treatment of adult spinal deformity. The addition of anterior fusions to posterior constructs offers increased construct stability, improved fusion rates, and better lordosis restoration. The anterior column is most commonly accessed by the anterior retroperitoneal approach, in which the anterior longitudinal ligament is resected, or by the lateral transpsoas approach, which offers the ability to either leave the anterior longitudinal ligament intact or resect it as part of anterior column realignment. Complications are mostly approach-related and include vascular, visceral, and neurological injury.