This area can be approached from the front of the spine by skirting the contents of the abdomen or directly from behind by navigating around the nerves and sac containing the nerves. Various delivery systems exist permitting surgeons to perform these surgeries with special instruments. Minimally invasive approaches to the interbody area from the front through the abdomen include larposcopic portals or mini-ALIF which involves a very small incision with a special table fixed retractor set to provide the exposure to the anterior interbody area. The advantages of approaching the spine from the abdomen is the direct access and complete visualization of the disc space (interbody area).

 
From behind, the interbody area can be approached with small endoscopic tubes allowing visualization and permitting the insertion of instruments to perform the interbody fusion while shielding the neurological structures. The advantage of the posterior approach is that it avoids the abdominal structures and is familiar to most surgeons.

With an increasing number of spine fusions performed each year, patients will appreciate these minimally invasive options with the potential for quicker recovery and less time in the hospital.

Words © 2002 William Dillin, M.D.

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