Abstract
Minimally invasive surgery (MIS) techniques for lumbar fusion have been undergoing a development and evolution for the past two decades. As such, they are continuously being validated by clinical and radiological studies. Among various surgical methods, the approach to the anterior column of the lumbar spine with a lateral and transpsoas procedure was innovated and popularized by Pimenta in 2001, who described the procedure as an “extreme lateral interbody fusion” (XLIF) [1]. Whether it is called lateral lumbar interbody fusion (LLIF), direct lateral interbody fusion (DLIF), or XLIF, this surgical approach offers several advantages comparing to traditional methods for interbody fusion, including the avoidance of mobilization of great vessels, less operative time, and reduced blood. In addition, there is no requirement for retraction of the nerve roots or the need for an approach surgeon (such as with true anterior approaches). The application of such MIS techniques and its application as a more sophisticated procedure to treat adult deformity undoubtedly have been a powerful tool in the surgical armamentarium in the new millennium.