Oblique Lateral Retroperitoneal Approach to L5–S1

Abstract

The O51 procedure is essentially a laterally positioned traditional ALIF retroperitoneal approach. It requires much less dissection of the retroperitoneal space and can be done with a smaller incision using semi-constrained retractors. Orientation to the lateral disc position may be disorientating in the first 10–20 exposures, but quickly becomes routine as wide exposure of the disc occurs, no differently than what is visualized with ALIF. The much smaller exposure in O51 is facilitated by unique lit retractors and anatomic benefits of the laterally positioned patient which allows the entire abdominal contents to fall away from the spine, requiring significantly less abdominal retraction forces than a supine midline exposure.