Anterior lumbar vertebrectomy via direct anterior approach: technical note

The authors report the case of a 67-year-old female who presented with progressive worsening of low back pain for a period of 3 to 4 weeks, with acute severe deterioration over one week associated with left quadriceps weakness and absence of knee reflex. Imaging reveals a lytic lesion on the L4 vertebral body, with a pathological fracture. Positron emission tomography (PET) revealed significant uptake in the L4 vertebral body and minimal uptake in the lungs. Surgical removal of the lesion was recommended as the choice of treatment. An anterior approach for a complete vertebrectomy and a conventional minimally invasive posterior approach for lumbar interbody fusion 3 days postanterior vertebrectomy was planned. The anterior approach for complete L4 vertebrectomy was documented in the presented video.