By Laura Dyrda
Lateral spine surgery has been an effective procedure for the past decade; now, Oblique Lateral Interbody Fusion(OLIF at L2-L5) gives surgeons lateral access while preserving the psoas and avoiding the iliac crest.
Three spine surgeons discuss the oblique lateral approach. 
Q: How have your surgical techniques dealt with the psoas over your career?
Kamal Woods, MD, CFO, Advanced Neurosurgery Associates, Murrieta, Calif.: Early in my neurosurgical training, I did not have a lot of exposure to the retroperitoneal space, with the exception of a handful of retroperitoneal tumors. Later on, I was introduced to the trans-psoas approach, guided by triggered EMG, and immediately realized that this approach was potentially powerful in treating a number of pathologies. However, the trans-psoas approach brought its own setbacks.
Neel Anand, MD, Director of Spine Trauma, Cedars-Sinai Spine Center, Los Angeles: Historically, we always went through the middle of the psoas. The plexus and the nerves are there, so I started to enter more anteriorly a while ago for less psoas disruption. I transitioned to doing more of the oblique procedure around 2010 and realized it’s a better way to go.