الفهرس 
introductionOnly 14 pages are availabe for public view
 |  | from | 109 |  |  |
| | | from | 109 | | |
Abstract
The lateral approach to the lumbar spine is a powerful new tool that provides direct access to the anterior spinal column without many of the limitations of traditional anterior and posterior approaches, affording unparalleled access to the intervertebral space without the need for transgression of the neural elements or abdominal viscera. It is ligament sparing and muscle sparing, offering advantages over PLIF and TLIF procedures, and does not require the assistance of an access surgeon such as with the ALIF procedure. Furthermore, complications such as durotomy, arachnoiditis, and epidural fibrosis problems with which spine surgeons have become all too familiar are not of significant concern with the lateral approach.Still, the lateral approach is itself associated with a host of potential approach-related complications. Neurologic complications are a significant concern with the lateral approach and are primarily the result of blunt or traction injury to the lumbar plexus or one of its branches such as the genitofemoral nerve. Direct trauma to the psoas muscle, even when minimal, typically produces transient anterior thigh pain and hip flexor weakness in many patients. Of great concern is the potential for catastrophic injuries to the retroperitoneal viscera, principally the colon and great vessels. Finally, the potential for graft related complications, including endplate violation and subsidence, is significant particularly if discectomy and endplate preparation are too aggressive and if too large a graft is chosen.