History of anterolateral spine surgery

Anterolateral approaches to the spine have become essential for addressing a variety of spinal pathologies, offering an alternative to traditional posterior methods. These techniques, though effective, present anatomical challenges that require continuous innovation to improve safety and clinical outcomes. With an aging population demanding safer and less invasive procedures, spine surgeons increasingly rely on anterolateral approaches to treat conditions such as degenerative disc disease, spondylolisthesis, and deformities. Historical developments, including Ménard's lateral extracavitary approach, Müller's anterior lumbar access, and Hodgson and Stock's anterior spinal fusion, have shaped these techniques. Advancements like the retroperitoneal ALIF, mini-open variations, XLIF and ATP procedures have refined the approach, reducing morbidity and accelerating recovery. The shift to minimally invasive techniques has improved surgical outcomes, and as demand for these surgeries grows, further refinement of anterolateral techniques promises to enhance safety and efficacy in managing complex spinal disorders. This review summarizes the history and progress of anterolateral spine surgery.