Surgical technique: Lateral interbody fusion for adult spondylolisthesis

Abstract

Spondylolisthesis is one of the most common conditions of the spine, and several surgical treatments have been utilized to benefit those patients who undergone intervention, in an attempt to improve pain and function outcomes when compared to conservative care. The advent of minimal invasive spine surgery (MISS) allowed the achievement of good clinical and radiological results while minimizing complications related to open surgeries. One of these techniques is the eXtreme Lateral Interbody Fusion (XLIF) that offers various clinical advantages over more traditional techniques. This less invasive procedure realigns the endplates to a horizontal position through bilateral annular release, allows the placement of a large implant across the disc space spanning the ring apophysis. Besides, ligamentotaxis restores disc and foraminal heights, indirectly decompressing the neural elements, promoting stabilization and fusion through an anterior intervertebral fusion diminishing vertebral slippage and increasing focal and global lordosis. This chapter describes in detail the minimally invasive transpsoas approach in the treatment of spondylolisthesis, presenting nuances in technique, surgical pitfalls, and current results already published in literature.