Anterior to Psoas/OLIF Approach for Adult Spondylolisthesis

Degenerative spinal disease (DSD) is the main pathology among patients referred to neurosurgeons. Neurosurgical approaches to DSD draw on a vast armamentarium of anterior, lateral, or posterior spinal fusion techniques to manage and treat spinal diseases as diverse as spondylolisthesis, degenerative disc disease, recurrent disc herniation, pseudarthrosis, and spinal deformity. Choosing the optimal technique on a case-by-case basis can help minimize the risk of comorbidities associated with blood loss and length of hospitalization and to maximize postoperative fusion rate and clinical outcome for all patients, including those planning to return to their professional or sporting career. Here we briefly discuss the differences between the anterior and posterior approaches, focusing mainly on the surgical technique and main features of the oblique lateral interbody fusion (OLIF). The OLIF procedure is fast becoming an attractive choice for spine surgeons on account of the overall benefits associated with reduced damage to soft and nerve tissues and the sparing of the posterior structure. In the absence of major evidence-based indications in the literature with regard to the relative advantages and disadvantages of OLIF in cases of lumbar spondylolisthesis, this chapter aims to provide an illustrative overview of this case scenario, inclusive of a full description, surgical tips, and operative strategies.