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BACKGROUND Anterior lumbar interbody fusion finds a place in L5-S1 isthmic spondylolisthesis (ISPL) treatment. Extension of this arthrodesis at L4-L5 level is sometimes required. Anterior approach of the L4L5 disc is considered difficult due to the anatomical relationship between the iliocava junction (ICJ) and the spine. HYPOTHESIS Does the lumbosacral deformation induced by ISPL allows anterior approach of L4-L5 disc between the iliac? STUDY DESIGN Retrospective radiographic analysis of consecutive patients. METHODS This retrospective