Surgical Innovation Spotlight: Dr. Roy Vingan and the Lateral Approach for Spinal Fusion Surgery

When Dr. Roy Vingan, co-founder of New Jersey Brain and Spine, first encountered lateral access spine surgery nearly two decades ago, he saw more than a new surgical route. He saw the future of spine surgery.

He first heard about the lateral approach in 2006, and flew out to San Diego to train on it. “Like any new procedure, there’s a learning curve. By my third case I realized it was challenging, but I knew it was worth mastering,” says Dr. Vingan.

A new angle on spinal fusion

Traditionally, spinal fusion surgeries are performed from the back (posterior) or front (anterior). Lateral access, also known as lateral lumbar interbody fusion, takes a side approach to the spine through an incision on the side. This particular path allows surgeons to go through just a few muscle layers, navigate behind the abdominal cavity, and access the disc space without needing a vascular surgeon.

“The lateral approach allows us to put in a larger cage that spans the entire disc space,” he explains. “That means more bone contact, better alignment, and stronger fusion.”

Dr. Vingan compares the structural advantage of larger cages and more bone contact to sealing bricks together: “You don’t want a small bit of mortar between them—you want a full layer. The more surface area, the better the fusion.”

From early adopter to lateral access expert

When Dr. Vingan began training in the lateral access technique, he was one of the earliest surgeons in the Northeast to bring it into practice. He learned directly from the innovators who developed it, then honed his skills through hundreds of procedures and national workshops with the Society of Lateral Access Surgery, a collective of surgeons committed to refining the approach.

That persistence paid off. Today, Dr. Vingan has performed more than a thousand lateral fusion levels and is recognized for his technical proficiency and clinical judgment. That experience gives his referring physicians confidence that their patients are in the hands of one of the most seasoned lateral surgeons in the region.

Better outcomes, faster recovery

For patients, the benefits are tangible. The side incision avoids the large muscle dissection required in traditional posterior fusions. It also restores the disc height in such a way that puts spinal ligaments back on tension, which stabilizes the spine naturally. These factors often translate to less postoperative pain and faster recovery.

Dr. Vingan explains that he used to keep patients in braces for months after surgery. But with the lateral approach, “for the most part, my patients are doing pool-based therapy within the first few weeks, and they move better than they would with older techniques.”

Innovation that endures

Over time, many surgeons have explored different “minimally invasive” fusion techniques. But for Dr. Vingan, lateral access remains one of the most thoughtfully engineered tools in modern spine care. It’s also underutilized. He estimates that only about 20 percent of spine surgeons nationwide have adopted the approach.

Ultimately, lateral access is a worthy approach for most lumbar fusion cases from L4-5 and above. “Everyone who does lateral efficiently finds they have to look for a reason not to do it, not a reason to do it,” explains Dr. Vingan. Contraindications for lateral access are the same as those for general spine fusion and could include patients who have a complex autoimmune disease, untreated osteoporosis, or are too elderly or ill.

“After a few years of really advancing my skills, it became second nature,” Dr. Vingan explains. “It’s a novel technique to learn, but when you get good at it, it’s efficient, safe, and reproducible.”

Referral Takeaway

When to consider a lateral access fusion surgery:

• Ideal candidates: degenerative disc disease, spinal instability, or scoliosis between L1–L5.
• Key benefits: faster recovery, less postoperative pain than posterior fusions.
• Best suited for: restoring disc height, alignment, or correcting mild slippage.

About Dr. Roy D. Vingan, MD, FAANS, FACS

Dr. Roy D. Vingan, a founding member of NJBS, is recognized nationally for his expertise in spinal surgery and minimally invasive techniques. In practice for nearly three decades, he has focused primarily on treating patients with spinal conditions for the past 15 years. He has held several leadership positions over the span of his career and is currently vice chairman of the Department of Neurosurgery, co director of spine surgery, and chief of minimally invasive surgery at Hackensack University Medical Center.