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Alexander A. Theologis, Ehsan Tabaraee, Paul Toogood, Abbey Kennedy, Harjus Birk, R. Trigg McClellan and Murat Pekmezci

T raditional open anterior approaches to the lumbar spine are associated with significant morbidity. 12 Complications associated with open anterior approaches include major vascular injury, pulmonary embolism, postoperative ileus, retrograde ejaculation, incisional hernias, and superficial and deep wound infections. 12 Thus, the use of less-invasive and alternative anterior approaches to the lumbar spine has gained popularity. Ozgur et al. First described the effectiveness and safety of the mini-open, extreme lateral, transpsoas approach for access to

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Ricky Madhok and Adam S. Kanter

The authors present 2 cases of far-lateral lumbar disc herniations treated surgically via an extreme-lateral transpsoas approach. The procedure was performed using the MaXcess minimally invasive retractor system to access and successfully remove the disc fragments without complication. To the authors' knowledge, these are the first reported cases of using a minimally invasive retroperitoneal approach for the treatment of far-lateral disc herniations.

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David O. Okonkwo and Praveen V. Mummaneni

colleagues report on their software for presurgical planning of sagittal imbalance that also allows virtual surgical manipulation of the spine to test putative constructs. The authors are making this “freeware” available to colleagues in the field. Several articles appear regarding the extreme-lateral, transpsoas approach in the treatment of scoliosis, one from the University of Pittsburgh group, one from the University of South Florida group, one from the Cedars-Sinai group, and one from the University of Miami/University of California, San Francisco. The extreme

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Neginder Saini, Mohammad Zaidi, Maureen T. Barry and Robert F. Heary

SS , Eck JC , Groff MW , Ghogawala Z , Watters WC III , : Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 11: interbody techniques for lumbar fusion . J Neurosurg Spine 21 : 67 – 74 , 2014 10.3171/2014.4.SPINE14276 24980588 21 von Keudell A , Alimi M , Gebhard H , Härtl R : Adult degenerative scoliosis with spinal stenosis treated with stand-alone cage via an extreme lateral transpsoas approach; a case report and literature review . Arch Bone Jt Surg 3 : 124 – 129

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Matthew J. Tormenti, Matthew B. Maserati, Christopher M. Bonfield, David O. Okonkwo and Adam S. Kanter

which TLIF or PLIF techniques were used. Eight patients underwent deformity correction via a combined A/P approach. Anterior interbody fusion was performed via an extreme lateral transpsoas approach, and 4 patients underwent deformity correction via a posterior-only approach. Laterally placed interbody spacers contained either Actifuse synthetic bone graft material (ApaTech, Inc.) or demineralized bone matrix ( Table 1 ). All posterior instrumentation was placed via an open posterior approach. Posterior arthrodesis was performed at all instrumented levels by using a