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Updated: May 20, 2026
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Complications of the mini-open anterolateral approach to the thoracolumbar spine
Ali A Baaj1, Elias Dakwar, Tien V Le
1Department of Neurological Surgery, 2A Columbia Drive, University of South Florida, Tampa, FL 33616, USA.
Abstract:
The mini-open anterolateral approach to the thoracolumbar spine is gaining popularity as a minimally-invasive alternative to traditional open thoracolumbar approaches. Published studies reporting and discussing the complications associated with this minimally invasive approach, however, are limited. We performed a retrospective review of patients undergoing the mini-open lateral approach to the thoracolumbar spine for corpectomy/fusion. Intraoperative and postoperative complications are reported and analyzed. Eighty consecutive patients underwent the mini-open lateral approach with corpectomy and fusion for trauma (71%), tumor (26%) and infection (3%). Total complication rate was 12.5% (dural tear 2.5%, intercostal neuralgia 2.5%, deep vein thrombosis 2.5%, pleural effusion 1.3%, wound infection 1.3%, hardware failure 1.3%, hemothorax 1.3%). Two patients needed a re-operation to address the complication (hardware failure, hemothorax). There were no postoperative neurological complications. The mini-open anterolateral approach to the thoracolumbar spine is an appealing alternative to the traditional open approaches. This technique, however, is technically demanding and requires proficiency in the use of minimally invasive spinal surgery instruments and retractors.
Insights
The mini-open anterolateral approach for thoracolumbar spine surgery offers a less invasive option. This study reports a 12.5% complication rate, with no neurological issues, highlighting its potential benefits.
Area of Science:
- Spine Surgery
- Minimally Invasive Procedures
- Orthopedics
Background:
- The mini-open anterolateral approach is an emerging minimally invasive technique for thoracolumbar spine surgery.
- Limited data exists on the complications associated with this specific approach.
Purpose of the Study:
- To report and analyze intraoperative and postoperative complications of the mini-open lateral approach for thoracolumbar corpectomy/fusion.
Main Methods:
- Retrospective review of 80 consecutive patients undergoing the mini-open lateral approach for corpectomy and fusion.
- Analysis of complication rates, types, and need for re-operation.
Main Results:
- The overall complication rate was 12.5%, including dural tear, intercostal neuralgia, deep vein thrombosis, pleural effusion, wound infection, hardware failure, and hemothorax.
- Two patients required re-operation for hardware failure and hemothorax.
- No postoperative neurological complications were observed.
Conclusions:
- The mini-open anterolateral approach is a viable alternative to open procedures for thoracolumbar corpectomy/fusion.
- While effective, the technique is demanding and requires specialized skills in minimally invasive surgery.
