New trends in spinal surgery: less invasive anatomical approach to the spine. the advantages of the anterior approach in lumbar spinal fusion.

Aim To describe the history of anterior approach to lumbar spine from beginning minimal invasive techniques that authors have developed, and discuss its advantages drawbacks. Material methods The collected published data on evolution in spine, described potential different pathologies focusing minimally techniques. Results Several successful been developed over years, leading a progressive less anatomical exposure spine. Anterior approaches gained popularity as an alternative posterior routes management tumors, infections, traumas, degenerative or deformity diseases salvage procedure after surgery. Conclusion Advantages retroperitoneal are well accepted: it preserves structures abdomen tension band, avoiding muscle dissection. implantation lordotic cages with larger footprint improves local lordosis fusion rate even revision Drawbacks traditional may be: vascular injury, deep venous thrombosis, risk retrograde ejaculation male case L5-S1 Therefore, several decrease risks related approaches. However, long learning curve is required achieve good skills manage possible technical concerns complications.