LLIF is a relatively new approach and aims to have several advantages over the posterior approach. Some of these include:1
- Reduced risk of visceral and vascular injuries, incidental dural tears, and perioperative infections
- Preservation of both the anterior and posterior annular and ligamentous structures
- Favorable long-term outcomes.
However, as with most variations, the lateral approach also has associated complications, such as motor and sensory deficits.1
The lateral approach is also a suitable treatment option for younger and older patients, including fragile patients, due to generally shorter surgical time.
For this approach, working knowledge of retroperitoneal anatomy is crucial. This is due to individual variation, in particular, of the vascular structures and the lumbar plexus. These structures should be studied preoperatively through magnetic resonance imaging (MRI). Intraoperatively, patient positioning and X-ray usage are key to ensuring a safe and effective procedure.