A more recently developed lateral approach (from the side) may also be used and offers several advantages over the traditional approaches while maintaining the benefits of an anterior exposure of the spine. In this minimally invasive technique, the patient is positioned on his or her side.
The surgeon will identify the affected disc using x-ray and mark the appropriate position for a small, lateral incision. Through this incision, the psoas muscle is the only muscle that will need to be transversed.
Neurologic monitoring devices are used to dissect through the psoas muscle, lowering the risk of nerve injury. Once the disc space is exposed, the surgeon meticulously releases the deforming forces of the spine and prepares the bones for fusion. The damaged disc is removed and the specialized cage is implanted.
These far lateral techniques to access the spine may be combined with posterior approaches to obtain complete reconstruction of the spine. Alternatively, the anterior approach from a far lateral technique may be done as a stand-alone procedure for certain patients.
Benefits of the Lateral Approach
One benefit of the lateral approach is that incisions made in this position can be significantly smaller than incisions of the traditional approaches. In addition, approaching the spine from a lateral incision avoids many of the vital organs, muscles, and vessels that may be disrupted by the traditional approaches, decreasing the likelihood of post-operative abdominal muscle weakness and hernias.
As a result, patients who undergo surgery using this far lateral approach to the lumbar spine commonly experience less blood loss and tissue trauma, improved mobilization, and faster recovery times.