The Mercedes Benz Approach to the Lumbosacral Junction: A Technical Note

Posterior midline incision is the standard approach to the lumbosacral junction (LSJ). However, this approach has many limitations and can have complications. Few other incisions have been described but are mostly confined to sacral tumor excisions and often not suited to lumbosacral fixations. The authors describe the "Mercedes Benz" incision (MBI), which they have used extensively over the past two decades with satisfaction. The present report is a step-by-step guidance of the technical details of this novel approach and illustration of three cases. MBI approach is anatomical and therefore reduces denervation. MBI, by the approach described by the authors, provides excellent exposure of the LSJ, including the ilium, and can have wide indications with minimal complications.