Lateral lumbar interbody fusion surgery is an established minimally invasive fusion technique that delivers a large interbody cage via the retroperitoneal space. The anterior-to-psoas variation was advanced due to concerns with the trans-psoas technique causing injuries to the lumbar plexus and the obstruction by the iliac crest when approaching L4-5. By utilizing the corridor between the anterior vessels and the psoas, LLIF can be performed with comparable clinical and radiographic results while minimizing complications. The evolution of ATP LLIF includes lateral L5-S1 ALIF, lateral single position surgery, and technologies like navigation.
