[Advantages and disadvantages of retro- and transperitoneal approach for fusion of the presacral intervertebral disk].

In a retrospective study, we evaluated 180 patients treated for painful spondylolisthesis with combined anterior and posterior fusion. Group I included 90 patients treated by anterior fusion with the transperitoneal approach. Group II included 90 patients operated on with a retroperitoneal approach. Group II showed a higher incidence of pseudarthrosis L5/S1 (4%), tear of the common iliac vein (1%), postsympathectomy syndrome (4%) and reversible L4 nerve-root lesion (3%). On the basis of our findings, we recommend the transperitoneal approach for anterior interbody fusion L5 to S1 or L4 to S1.