BACKGROUND: The frequency of lumbar trauma in surgical emergencies at Niamey National Hospital, Niamey, Niger, is enormous. Injuries are most often amenable to an anterior or anterolateral approach, but because of a lack of expertise in surgical technique, they are usually operated on using a posterior approach. We aim to evaluate the management of lumbar spine fractures, including hinge fractures, using an anterior or anterolateral approach in a precarious context. METHODS: Retrospective and prospective observational descriptive study over 34 months including 28 patients who benefited from an anterior or anterolateral approach. The osteosynthesis material used was a bone graft fixed by a stainless steel plate and screws. The mean follow-up was 3 months. RESULTS: Anterior and anterolateral approaches had a hospital incidence of 3.16%. At follow-up, there was no neurologic deterioration, with an improvement in 75% of patients, despite deterioration of locoregional kyphosis in 76.92% of cases. One patient died in the immediate postoperative period and 1 died during medium-term follow-up. CONCLUSIONS: The anterior approach to the spine is a therapeutic arsenal that needs to be mastered. Efforts are still required to acquire suitable equipment for correct sagittal balance.