Objective:

To compare the technical nuances and approach-related morbidity of the anterolateral (AL) and posterolateral (PL) approaches for lumbar corpectomy, highlighting the clinical significance of these comparisons.

Key Findings:

• 64 articles reporting 702 patients were included, with 41 focusing on AL and 25 on PL approaches. AL corpectomies were primarily indicated for traumatic fractures (58.5%), while PL corpectomies were also common for trauma (73.9%). A median of 1 vertebral body was resected per patient, with expandable cages being the most commonly used for vertebral body replacement. These findings underscore the need for careful consideration of approach selection based on patient pathology.

Interpretation:

Both AL and PL approaches have distinct technical challenges and morbidity profiles, with AL traditionally favored for direct visualization but requiring additional posterior instrumentation. Understanding these differences is crucial for optimizing surgical outcomes.

Limitations:

• The majority of included studies were retrospective, which may introduce bias, particularly in patient selection and reporting. Limited data specifically addressing isolated outcomes for lumbar corpectomies further complicates the interpretation of results.

Conclusion:

The review highlights the need for further studies to better understand the outcomes and complications associated with both AL and PL approaches in lumbar corpectomy, particularly focusing on long-term patient outcomes and quality of life.