Extreme Lateral Lumbar Interbody Fusion Spine Surgery
For patients needing surgery to treat spinal disorders, New Hanover Regional Medical Center offers extreme lateral lumbar interbody fusion (XLIF®) surgery. XLIF® surgery is a minimally invasive spinal fusion procedure in which the spine is approached from the side (lateral) of the patient rather than the front or the back. This elminates passing through the abdomen or the muscles of the back, which can help minimize post-op pain.
Spinal Conditions Treated by XLIF®
XLIF® may be recommended to treat a variety of lumbar or lower spine disorders, including:
- Degenerative disc disease
- Recurrent disc herniation
- Degenerative scoliosis, a change in the normal curvature of the spine
- Degenerative spondylolisthesis, when one vertebrae slips forward over another
- Posterior pseudoarthrosis, a previous fusion surgery that did not fuse correctly
- Post-laminectomy syndrome, an instability of the spine that occurs after a previous non-fusion surgery
XLIF® cannot be used for all types of lumbar conditions for which spinal fusion is a treatment option, such as conditions at the lowest level of the spine. Discuss your condition with your physician to determine if XLIF® is right for you.
How the Surgery is Performed
XLIF® is performed under general anesthesia and takes about an hour. Steps of the surgery include:
The patient is positioned on his or her side on the surgical table. The surgeon will use x-ray to locate the disc to be removed.
One small incision will be made, over the side of the waist, from which the surgery will be performed, in a small number cases a second small incision might be required toward the back muscles which the surgeon uses to help guide the approach.
Special instruments called tubular dilators will be inserted through the muscle on the side of the vertebrae. X-rays and nerve monitoring will guide instruments to the appropriate location.
The damaged or diseased disc will be then be removed. An implant will be placed into the disc space to restore proper disc height and provide support while bone grows between the vertebrae during the healing process.
A final x-ray will be taken to confirm correct implant placement. Screws, rods or plates may be inserted to stabilize the spine for fusion. Your surgeon will determine if fixation is necessary.
A final X-ray image will ensure the implant is correctly placed.
Benefits of XLIF® Surgery
The XLIF® procedure can offer many benefits to spine patients, some of which could include:
- Reduced operative time – The XLIF® procedure can be completed in as little as one hour, reducing the amount of anesthesia time.
- Less blood loss during surgery – Less invasive procedure allows for less tissue disruption, resulting in reduced blood loss.
- Reduced postoperative pain – The XLIF® procedure does not require entry through back muscles, bones or ligaments, resulting in less postoperative pain.
- Reduced hospital stay – The XLIF® procedure typically requires only an overnight stay in the hospital, compared to several days of immobility and hospitalization with traditional open approaches.
- Faster return to normal activity – Patients are usually walking the same day after surgery. Recovery typically take around 6 weeks, compared to 6 months or more with traditional approaches.