The periumbilical incision for anterior lumbar interbody fusions

The traditional retroperitoneal approach for the anterior lumbar interbody fusion (ALIF) uses a longitudinal paramedian incision. In this study, we use a discrete periumbilical incision. A 270-degree semicircular incision is made around the umbilicus and the subcutaneous tissue is dissected radially at a 45-degree angle, creating a mound around the umbilical stalk. Once the anterior sheath is encountered, the steps of the operation converge with those of the traditional approach. In this study, 30 patients underwent a periumbilical ALIF with an average of 2.1 levels fused. Perioperative outcomes were comparable to those described in the ALIF literature. No patients experienced complications attributable to the periumbilical incision.