Spondylolisthesis that is symptomatic, progressive, or requiring decompression that necessitates stabilization

Degenerative disk disease with low back pain that can benefit from fusion at the symptomatic level or levels

Pseudarthrosis of a previous intertransverse fusion that requires a fusion technique with higher success at achieving a solid arthrodesis

Correction of degenerative scoliosis

Recurrent disk herniation

Previous interbody graft placed at index level

Significant epidural scar at planned level or site of operation

Osteoporotic end plates that may not hold interbody graft, leading to subsidence

Disease at or above the conus medullaris

Neurophysiologic monitoring including somatosensory evoked potentials and electromyography is routinely used.

The operative table should be positioned to enable fluoroscopy access and visualization of the surgical levels.

Preoperative imaging should include anteroposterior and lateral radiographs or computed tomography (CT) for defining bony anatomy and magnetic resonance imaging (MRI) for defining neural elements and soft tissue structures.

Neurophysiologic monitoring including somatosensory evoked potentials and electromyography is routinely used.

The operative table should be positioned to enable fluoroscopy access and visualization of the surgical levels.

Preoperative imaging should include anteroposterior and lateral radiographs or computed tomography (CT) for defining bony anatomy and magnetic resonance imaging (MRI) for defining neural elements and soft tissue structures.