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Article summary:

1. Anterior approaches to the lumbar spine are increasingly used for fusion, with several techniques developed depending on the level to be treated.

2. Minimally invasive approaches with video assistance and sophisticated anterior spinal instrumentation systems have replaced conventional techniques, reducing risk and morbidity.

3. Each approach and type of fixation has specific technical requirements that need to be mastered to minimize risk, and there are pros, cons, and contraindications to consider when deciding on anterior lumbar surgery.

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