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How to perform the Wiltse posterolateral spinal approach: Technical note.

A Guiroy1,2, A Sícoli1, N Gonzalez Masanés1

  • 1Spine Unit, Orthopedic Department Hospital Español, Mendoza, Argentina.

Surgical Neurology International
|March 13, 2018
PubMed
Summary

The Wiltse paraspinal approach is a minimally invasive technique for lumbar spine surgery. It offers benefits like reduced bleeding, shorter hospital stays, and fewer infections.

Keywords:
Lumbar spineWiltse approachminimally invasive spine surgerymuscle sparing approachparaspinal approach

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Area of Science:

  • Spine surgery
  • Minimally Invasive Surgery (MIS)

Background:

  • The Wiltse approach, also known as the paraspinal or posterolateral approach, is a long-standing technique that aligns with minimally invasive surgery (MIS) principles.
  • This study aims to detail the Wiltse paraspinal approach using existing literature and analyze its advantages and limitations.

Purpose of the Study:

  • To provide a comprehensive, step-by-step description of the Wiltse paraspinal approach for lumbar spine surgery.
  • To analyze the primary benefits and drawbacks of this muscle-sparing surgical technique.

Main Methods:

  • A literature review was conducted using PubMed and Lilacs.
  • Search terms included "Wiltse approach," "paraspinal approach," "muscle sparing approach," and "lumbar spine."
  • Ten relevant papers were synthesized to detail the surgical steps from preparation to closure.

Main Results:

  • The Wiltse approach is predominantly characterized by its minimally invasive nature.
  • Key advantages identified include minimal intraoperative bleeding, reduced hospital length of stay, and a low rate of surgical site infections.

Conclusions:

  • The Wiltse approach is fundamentally a minimally invasive technique that preserves muscle planes and soft tissues.
  • It facilitates extensive far lateral lumbar decompression, discectomy, and fusion with a low overall complication rate.