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Lumbarinterbodyfusion Techniquesandcomparison Introduction Lumbarinterbodyfusion LIF placementofanimplant cage spacerorstructuralgraft withintheintervertebralspaceafterdiscectomyandendplatepreparation FivemainapproachesInterbodyfusion lowerratesofpostoperativecomplicationsandpseudoarthrosis TechniquereviewPLIF OneoftheoriginalapproachesInitialdescriptionofthePLIFtechniquebyBriggsandMilliganin1944 PLIF PLIF Techniquereview Techniquereview TechniquereviewTLIF Openingtheneuralforamenononesideonly HarmsandRolingerreportedin1982Direct unilateralaccesstotheintervertebralforaminalspacewhilstreducingdirectdissectionandduraltears TLIF TLIF PreservesligamentousstructureswhichareinstrumentaltorestoringbiomechanicalstabilityofthesegmentandadjacentstructuresAsingleunilateralincisionisabletoprovidebilateralanteriorcolumnsupport TechniquereviewALIF AnterioraccesscorridorsforlumbarfusionhavebeenusedanddevelopedsincetheywereintroducedbyCarpenterin1932 Theanteriorretroperitonealapproachtotheventralsurfaceoftheexposeddisc allowingcomprehensivediscectomyanddirectimplantinsertion SuitableforlevelsL4 L5andL5 S1 ALIF ALIF Disadvantages Retrogradeejaculationvisceralandvascularinjury TechniquereviewLLIF DescribedbyOzguretal in2006SuitableforT12toL5 ThistechniqueisnotsuitablefortheL5 S1level NeuromonitoringisessentialSuitableforalldegenerativeindications Especiallyforsagittalandcoronaldeformitycorrection lumbardegenerativescoliosiswithlaterolisthesis Notbesuitableforseverecentralcanalstenosis bonylateralrecessstenosisandhigh gradespondylolisthesisNotbesuitableforpriorretroperitonealsurgeryorwithretroperitonealabscess aswellaspatientswithabnormalvascularanatomy LLIF Advantage MISmuscle splittingapproachthatcanbeperformedwithrapidpostoperativemobilization Aggressivedeformitycorrectioncanbeachievedwithhighfusionratesandcomprehensivediscspaceclearance Disadvantages Potentialrisksoflumbarplexus psoasmuscleandbowelinjury particularlyattheL4 5level Vascularinjury ifitoccurs maybedifficulttocontrol TechniquereviewOLIF FirstdescribedbyMichaelMayerin1997andinvolvesanMISaccesstothediscspaceviaacorridorbetweentheperitoneumandpsoasmuscleThephrase obliquelumbarinterbodyfusion orOLIFwasfirstcoinedbySilvestrein2012SimilarlytoanLLIFapproach OLIFdoesnotrequireposteriorsurgery laminectomy facetectomyorstrippingofspinalorparaspinalmusculature OLIFtechniquedoesnotdissectortraversethepsoasmuscleandneuromonitoringisnotnecessary OLIFtechniqueissuitableforlevelsL1 S1 IndicationsandcontraindicationsaresimilartoLLIF OLIF OLIF Advantage LLIF lessriskoflumbarplexusandpsoasmuscledamage Disadvantages Potentialrisksofincludesympatheticdysfunctionandvascularinjury SilvestreC Mac ThiongJM HilmiR etal Complic

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