Table 1: Benefits and disadvantages of the different surgical approaches.

 

Benefits

Disadvantages

ALIF

• Less bleeding

• Lower lumbar segments only

• Big surface for cage placement

• Visceral or vessels damage

• Less muscular damage

• Retrograde ejaculation

• Better lordosis restoring

• Post incisional hernias

LLIF

• Less bleeding

• Hip flexion pain

• Big surface for cage placement

• Visceral or vessels damage

• Less muscular damage

• Less lordosis restoring

• Fast surgical timing

• Post incisional hernias

• Upper and lower segments

 

PLIF

• Only one approach

• Most dural tear incidence

• Almost none visceral or vessels damage

• Dural sac retraction

• All lumbar segments

• More bleeding

• More muscular damage

• Less surface for arthrodesis

• Less lordosis restoring

• Laminae and partial or

complete facet resection

TLIF

• Only one approach

• Complete facet resection

• Minimal dural sac retraction

• Nerve root lesion

• Almost none visceral or vessels damage

• Dural tears

• All lumbar segments

• More bleeding

• More muscular damage

• Less surface for arthrodesis

• Less lordosis restoring