Retroperitoneal approach for interbody fusion of L4/L5 and L5/S1

Surgical Principles After resection of the anulus fibrosus through a retroperitoneal approach the vertebrae adjacent to the disc are stripped of periosteum on their anterior and lateral surfaces and bone grafting is extended to these areas. This allows vascular invasion of the fusion mass from all sides, maximizes the interface between bone graft and bone, and ensures the development of the fusion mass at the biomechanically most appropriate site in a manner resembling external callus formation in fracture healing. Revised Version from: Operat. Orthop. Traumatol. 1 (1989), 43–51 (German Edition).