Anterior Column Reconstruction for Sagittal Plane Deformity Correction

  • Gurpreet S. Gandhoke
  • Zachary J. Tempel
  • Adam S. KanterEmail author


Since the addition of the lateral access corridor to the spinal surgeon’s armamentarium, indications for its applications have broadened over time. Classically, spine surgeons have employed the minimally invasive (MIS) transpsoas lateral lumbar interbody fusion (LLIF) approach to treat degenerative disc disease and low-grade spondylolisthesis. However, with an increasing demand for effective MIS tools in spinal deformity surgery, surgeons have focused on advanced techniques for restoring sagittal balance through the lateral corridor. The MIS lateral anterior column reconstruction (ACR) is being used as a lordosing technique that may obviate the need for osteotomies (vertebral column resection, pedicle subtraction osteotomy) in appropriately selected deformity patients. Release of the anterior longitudinal ligament (ALL) enables anterior column wedging to induce lumbar lordosis, providing a potential MIS option for treating moderate to severe sagittal plane deformity. In this chapter, we discuss the nuances of the anatomy and surgical technique of the MIS lateral ACR, review the available literature, present the results of our experience with this technique, and highlight the associated dangers and complications.


LLIF Anterior column reconstruction Anterior longitudinal ligament release Hyperlordosis Adult spinal deformity 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gurpreet S. Gandhoke
    • 1
  • Zachary J. Tempel
    • 2
  • Adam S. Kanter
    • 3
    Email author
  1. 1.Saint Luke’s Hospital and Marion Bloch Neuroscience InstituteKansas City, MOUSA
  2. 2.Mayfield Brain & SpineCincinnatiUSA
  3. 3.Department of Neurological SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA

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