• Li Jia Xi Julian JX NeuroSpine Surgery Research Group (NSURG), NeuroSpine Clinic, Prince of Wales Private Hospital, Randwick, NSW, Australia; Faculty of Medicine, Univers, Kevin Phan, and Ralph Mobbs.
• NeuroSpine Surgery Research Group (NSURG), NeuroSpine Clinic, Prince of Wales Private Hospital, Randwick, NSW, Australia; Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia.
• World Neurosurg. 2017 Feb 1; 98: 113-123.

ObjectiveAnterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) are commonly used approaches for lumbar spine fusion surgery, each with their own unique advantages and disadvantages. ALIF requires mobilization of the great vessels and peritoneum, and dissection of the psoas muscle in the LLIF technique is associated with postoperative neurologic complications in the proximal lower limb. The anterior-to-psoas (ATP) or oblique lumbar interbody fusion (OLIF) technique is the proposed solution to accessing the L1-L5 levels without the issues encountered with ALIF and LLIF. In this review, the technical nuances, operative outcomes, and complications with the ATP/OLIF technique in the current literature are summarized.MethodsA systematic search of the literature was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data collected included operative time, blood loss, postoperative hospital stay, and complications, which were then pooled together.ResultsFrom the 16 studies selected, the mean blood loss was 109.9 mL, average operating time was 95.2 minutes, and mean postoperative hospital stay was 6.3 days. Fusion was achieved in 93% of levels operated. Incidence of intraoperative and postoperative complications was 1.5% and 9.9%, respectively. Transient thigh pain and/or numbness and hip flexion weakness occurred in 3.0% and 1.2% of patients, respectively.ConclusionsEarly results on the ATP/OLIF technique are promising and warrant further investigation with well-designed prospective randomized studies to provide high-level evidence of the potential advantages over the ALIF and LLIF approaches.Copyright © 2016 Elsevier Inc. All rights reserved.

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