Minimally Invasive L4-5 Oblique Lumbar Interbody Fusion With Robot-Assisted Single-Position Posterior Fixation: 2-Dimensional Operative Video

We present here a 58-year-old female patient with L4-5 spondylolisthesis, who underwent a minimally invasive L4-5oblique lumbar interbody fusion (OLIF) with robot-assisted bilateral posterior instrumentedfixation in a single lateralposition (Mazor X Stealth Edition, Medtronic).There has been interest in detailed video-based descriptions of single-position surgery with lateral approach interbodyfusions, either in the prone or lateral decubitus position.1-6Particularly, the addition of robotics has been shown to helpincrease overall operating efficiency in the lateral position with reduced case times even with the increased up-frontrobot setup time.(7,8)The OLIF, also known as an anterior-to-psoas approach, allows for single-position posteriorfixationand can be very effective at L4-5 where the anatomy of the iliac crest or lumbar plexus does not preclude this surgicalcorridor the way it could in the transpsoas lateral lumbar interbody fusion. Clinical outcomes between these 2 lateralapproaches have been shown to be very good,(9)and OLIF has reduced blood loss while still restoring alignmentparameters compared with anterior lumbar interbody fusion, with better fusion and reduced subsidence compared withtransforaminal lumbar interbody fusion.(10,11) To our knowledge, this is thefirst video demonstrating a view of the OLIF approach through a high-definition retractor-based camera (MaxView Camera, Viseon Inc). There is no identifying patient information in this video. The participants and any identifiable individuals consented topublication of his/her image, and the patient consented to the procedure.