Endo-OLIF is a combined minimally invasive spinal approach which takes full advantages endoscopic spine surgery, O-arm navigation, and minimally invasive technique for anterior spinal fusion. 
 
The OLIF procedure is an oblique approach intermediary between an anterior lumbar interbody fusion (ALIF) and a direct lateral lumbar interbody fusion (DLIF). Unlike the ALIF procedure, all major blood vessels are avoided in this approach, and unlike the DLIF procedure, psoas muscles and lumbar plexuses are left undisturbed thereby reducing the risk of postoperative pain and neurological/plexus injury. Occasionally, low-lying rib cage or high iliac crest position is found in some people making it impossible with the direct lateral approach (DLIF) to gain access to high lumbar disc spaces (L1/2 and L2/3) or lower lumbar spaces (L4/5 and L5/S1). By contrast, the oblique approach can access most lumbar disc spaces from L1/2 to L4/5 without difficulties, as it is not hindered by the rib cage or the iliac crest.
 
The Endo-OLIF offers many advantages over traditional lumbar fusion surgery. In older patients, the benefits become much more obvious with less wound pain, less blood loss, and shorter hospital stay. The OLIF implant/cage is wider providing more stability and better support for the anterior spinal column (advantageous in osteoporotic bone). In addition, better correction of lumbar scoliosis and lordosis can be achieved by using larger OLIF implants and by inserting the implant from an oblique/lateral direction (the same direction plane as the scoliotic deformity). 
 
The Endo-OLIF procedure is often used in combination with other minimally invasive posterior procedures, such as endoscopic lumbar decompression and/or percutaneous pedicular screw placement. By combining O-arm navigation and spinal endoscopy with the OLIF procedure, surgical precision and better visualization of important anatomical structures can be achieved, thus increasing overall safety and providing better clinical outcome for patients.