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Blake N. Staub and Paul J. Holman

authors. Drafting the article: Staub. Critically revising the article: both authors. Reviewed submitted version of manuscript: both authors. Approved the final version of the manuscript on behalf of both authors: Staub. Administrative/technical/material support: Holman. Study supervision: Holman. References 1 Ahmadian A , Verma S , Mundis GM Jr , Oskouian RJ Jr , Smith DA , Uribe JS : Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4-5 spondylolisthesis: clinical outcomes . J Neurosurg Spine 19 : 314 – 320

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Mohammed Ali Alvi, Redab Alkhataybeh, Waseem Wahood, Panagiotis Kerezoudis, Sandy Goncalves, M. Hassan Murad and Mohamad Bydon

. 21 A commonly used surgical technique in treating pathologies of the spine is transpsoas lateral lumbar interbody fusion. The technique was first described by Ozgur et al. in 2006 and has since been endorsed by many spine surgeons. 36 There have been several studies since its first description highlighting the improved outcomes, ease of access, and lower/comparable complications when compared to other conventional approaches. 1 , 7 , 8 , 12 , 13 , 18 , 19 , 27 , 28 One of the prime objectives is to minimize collateral tissue and muscle trauma while ensuring

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Joshua M. Beckman, Berney Vincent, Michael S. Park, James B. Billys, Robert E. Isaacs, Luiz Pimenta and Juan S. Uribe

R etroperitoneal transpsoas lateral lumbar interbody fusion (LLIF) is an increasingly popular but technically demanding procedure. Although it is considered minimally invasive by many, this does not underscore the increased risk profile that is accompanied by a procedure highly dependent on positioning, electromyographic stimulation, and fluoroscopic guidance rather than direct visual conformation of anatomical structures. Despite meticulous surgical technique and detailed preoperative planning, complications are still reported. For surgeons to improve

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Corey T. Walker, S. Harrison Farber, Tyler S. Cole, David S. Xu, Jakub Godzik, Alexander C. Whiting, Cory Hartman, Randall W. Porter, Jay D. Turner and Juan Uribe

and posterior soft tissue structures, which can be particularly beneficial in instances of prior laminectomy defects or wound healing issues. 26 Moreover, they share many of the advantages of other minimally invasive spine techniques, such as low blood loss, decreased pain, fewer infections, and minimized devascularization/denervation that comes with traditional open approaches. 33 , 61 , 64 , 78 Approaching the vertebral body from the patient’s side can be accomplished through a direct (or extreme) lateral approach in a transpsoas fashion (lateral lumbar interbody

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Armen R. Deukmedjian, Tien V. Le, Ali A. Baaj, Elias Dakwar, Donald A. Smith and Juan S. Uribe

transpsoas approach. This approach may provide comparable lordosis correction by lengthening the anterior spinal column with placement of a hyperlordotic cage. 38 This is a relatively new technique; thus there is a paucity of clinical data and information on the surgical anatomy of the ALL. The goal of this cadaveric study is to describe the ALL as it relates to the anterior lengthening procedure, and to determine the procedure's feasibility. A secondary goal is to show through 4 illustrative cases that ALL release, although technically demanding, should provide increased

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John K. Houten, Lucien C. Alexandre, Rani Nasser and Adam L. Wollowick

A lateral , transpsoas approach to achieve interbody fusion in the lumbar spine using either the XLIF or DLIF technique is an increasingly popular method to treat spinal degenerative disease. Purported advantages of this approach include avoidance of intrusion into the spinal canal, diminished blood loss, more rapid postoperative mobilization, and the ability to place a larger interbody implant to facilitate distraction and maximize the likelihood of successful fusion. 20 Dissection and dilation through the iliopsoas muscle places the lumbosacral plexus

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Akwasi Ofori Boah and Noel I. Perin

the morbidity included in injury to the viscera, lumbar plexus, abdominal wall, and surrounding structures. 9 , 12 , 14 In this technical note, we present a novel application for the minimally invasive resection of retroperitoneal nerve sheath tumors using a tubular retractor system for a lateral transpsoas approach to this tumor subtype (see Fig. 1 ). This technique has been described in the preexisting neurosurgical literature and its principles are not different from those of the aforementioned traditional approach. FIG. 1. Conceptual illustration of

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Daniel J. Blizzard, Michael A. Gallizzi, Robert E. Isaacs and Christopher R. Brown

L ateral interbody fusion (LIF) via the retroperitoneal transpsoas approach is an increasingly popular, minimally invasive technique for interbody fusion in the lumbar and thoracic spine. 4 , 5 This technique avoids many of the complications of traditional anterior and transforaminal approaches, including visceral and major vessel injury. However, LIF is associated with several specific risks, including postoperative hip flexion weakness and genitofemoral or lumbar plexus nerve injury as well as the inherent risk of any vertebral arthrodesis surgery

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Kevin S. Cahill, Joseph L. Martinez, Michael Y. Wang, Steven Vanni and Allan D. Levi

S ince its initial description in 2006, the lateral interbody fusion technique has been used in the treatment of a variety of pathological conditions of the lumbar spine. 13 As this minimally invasive transpsoas approach has gained more widespread acceptance and increased utilization, recent interest has focused on understanding the morbidity and complication profile of the procedure. Estimates of postoperative morbidity related to psoas muscle manipulation and sensory nerve injury have varied, but it is now widely accepted that a significant percentage

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Christopher K. Kepler, Amit K. Sharma, Russel C. Huang, Dennis S. Meredith, Federico P. Girardi, Frank P. Cammisa Jr. and Andrew A. Sama

indications for interbody fusion. Lateral transpsoas interbody fusion is a minimally invasive surgical technique that permits anterior column lumbar interbody fusion via a direct lateral transpsoas approach, described in a preliminary report that demonstrated a low complication rate in a small cohort of patients. 4 The polyetheretherketone cage used with the XLIF system (NuVasive Inc.) has been specifically developed for use with this approach. This cage is placed from the lateral aspect of the vertebral body and is wide enough to span the entire width of the vertebra so