Lateral Lumbar Interbody Fusion (XLIF)

Lateral lumbar interbody fusion is a surgical procedure that your doctor may recommend to relieve pain and reduce spinal instability in your lower spine if non-surgical treatments have failed. Also called extreme lateral interbody surgery (XLIF), it’s a minimally invasive spinal fusion procedure in which your surgeon operates through the side of your body instead of through the front or back.

Like other forms of spinal fusion, XLIF involves connecting two or more spinal discs together to permanently stop movement between them. When you’re looking for a highly skilled spine specialist, look no further than Premier Brain & Spine, where you find New Jersey’s top spine specialists.

Interbody fusion is a category of spinal fusion surgery that involves removing the disc and inserting bone or bone-like material in the space between two vertebrae that are causing persistent pain. The vertebrae gradually fuse together and heal into one solid bone. Several different conditions may benefit from treatment with lateral interbody fusion. Your NJ orthopedics doctor may recommend XLIF if you have a condition such as:

• Recurrent disc herniations
• Spondylolisthesis
• Lumbar degenerative disc disorder
• Scoliosis
• Spinal stenosis
• Spinal fractures

This type of spinal fusion can’t be used to treat problems at the lowest level of the spine, since the fifth lumbar and first sacral vertebrae can’t be accessed from the side. Other types of interbody fusion procedures for the lumbar spine include:

• Anterior lumbar interbody fusion (ALIF)
• Transforaminal lumbar interbody fusion (TLIF)
• Posterior lumbar interbody fusion (PLIF)

By accessing your spinal column from the side rather than from the front or back, the surgeon prevents damage to ligaments, bones and muscles in your back. The benefits of this minimally invasive procedure include:

• Small incisions or scars
• Minimal blood loss
• Minimal tissue damage
• Minimal discomfort after surgery

Compared to traditional surgery, the time needed to complete an XLIF procedure is shorter. Lateral lumbar interbody fusion can usually be completed in about an hour, which means you spend less time under anesthesia than you would with traditional surgery.

An interbody fusion can be done from the front, back or side, depending on the location of the disc that’s triggering your pain. For XLIF, the surgeon fuses the spine laterally, so you’re positioned on your side. The steps of the procedure include:

• 1. General anesthesia. You’re unconscious during the procedure.
  2. Incision. The surgeon makes one small incision on your back and one on your side.
  3. Minimally invasive procedure. Your doctor inserts a tube-like instrument into the incision on your side. Live images are used to monitor the positioning of the instruments.
  4. Real-time monitoring. Your nerves are closely monitored in real time to make sure they’re not being harmed.
  5. Disc removal. Once the surgeon has achieved direct access to your spine, the bad disc is identified and then removed.
  6. Bone graft. An implant filled with bone graft is inserted into the space.

An x-ray is taken to make sure the implant is properly in place before the incisions are closed. Your surgeon may use screws or rods to provide additional support and to hold the vertebrae together until they fuse as one bone.

Since the surgeon accesses your spine from the side, XLIF doesn’t involve disruption of back muscles or ligaments, which reduces the pain during recovery. Most patients are able to walk the day after surgery. You may be discharged after being observed that day or the next day after a night of observation. Your spine surgeon gives you instructions regarding:

• Pain medications
• Activities you should avoid
• When you can return to work
• Whether physical therapy is needed

Total recovery time needed varies, depending on your spinal condition, your age and other health concerns. Keep all follow-up appointments with the team at the spine surgery center so they can monitor your progress and answer any questions as they come up.

By the time any type of spinal fusion is considered by your doctor, you’ve most likely tried conservative forms of treatment, such as ice, heat, over-the-counter pain medication, physical therapy and injections. If you’re continuing to experience back pain or if you have other back-related conditions, such as numbness or tingling, your spine specialist may recommend XLIF.

You don’t have to live with back pain. Contact Premier Brain & Spine for an evaluation by highly experienced doctors. They take care of you and your back pain.