Lateral lumbar interbody fusion (XLIF) is a minimally-invasive procedure used to treat leg or back pain. The XLIF is one of a number of spinal fusion options that a surgeon may recommend to treat specific types of lumbar spinal disorders, such as lumbar degenerative disc disease, spondylolisthesis, scoliosis and deformity and some recurrent lumbar disc herniations and types of lumbar stenosis. The procedure is performed through the patient’s side, avoiding the major muscles of the back.
In traditional spinal surgery, the spinal column is approached by the spinal surgeon from the posterior (back) or the anterior (front) sides. Recent technological advances now allow the spinal surgeon to approach certain parts of the spine directly from the side (lateral access). It is felt that this can be a significantly less invasive approach for the patient. Recent studies have demonstrated a faster recovery from surgery when this approach is used.
In a lateral lumbar interbody fusion, the surgeon takes a side approach and centers the incision over the patient’s flank. With this approach, the surgeon can reach the vertebrae and intervertebral disks without moving the nerves or opening up muscles in the back.
Patients who are suffering from back and/or leg pain are potential candidates for the TLIF procedure. The causes of the pain may range from a natural degeneration of the disc space to some type of traumatic event.
During the surgery, the patient is placed in the side position and the table is bent to provide the surgeon with a maximum view of the spine.
In some cases, an instrument called a tubular retractor is inserted through the skin and soft tissues down to the spinal column. The tubular retractor holds the muscles open and gives the surgeon a clear view of the spine.
During the procedure, the disk is removed and a cage packed with bone graft is inserted between the vertebrae. Titanium screws are used to hold the cage in place. In some cases, an additional incision is made on the back to insert the screws.