Extreme Lateral Interbody Fusion

Extreme lateral interbody fusion (XLIF) is a surgical technique for spinal fusion that provides access to the spinal column with minimal disruption to your nerves and other important nearby structures. Surgeons can use this technique as part of overall treatment for a variety of problems affecting your lumbar spine (lower back). Some surgeons also use XLIF to address certain problems in the thoracic spine (upper back).

Basics of the Procedure

Interbody fusion is a general surgical technique used to fuse together neighboring spinal bones (vertebrae) in the aftermath of removal of a damaged spinal disc, which normally sits between the vertebrae and cushions them. The procedure is performed in order to stabilize the spinal column and fill the space previously occupied by the damaged disc. Surgeons achieve both of these goals by placing material, called a bone graft, into the gap between the two vertebrae. Over time, new bone grows up around this graft and helps form a single, solid bone mass from these separate, adjoining structures.

In most forms of disc surgery that involve interbody fusion, the surgeon approaches the site of the procedure from the front (anterior) or rear (posterior) of the body. However, both of these approaches come with a considerable risk for damage to important nearby structures, including a nerve cluster called the lumbar plexus, another nerve cluster called the hypogastric plexus, a number of major blood vessels and the membrane surrounding the abdominal cavity, called the peritoneum. As its name implies, extreme lateral interbody fusion is performed as part of a disc surgery performed from the side (lateral portion) of the body.

Benefits of the Procedure

By using a lateral approach to the body, extreme lateral interbody fusion avoids much of the potential for collateral damage associated with anterior and posterior fusion techniques. For this reason, the procedure is considered a minimally-invasive form of spinal fusion. In addition to the reduction of specific risks for tissue damage, like all minimally-invasive surgeries, XLIF provides a variety of general benefits when compared to more invasive procedures. They include reduced bleeding during and after the procedure, smaller incisions at the site of the procedure, smaller scars in the aftermath of the procedure, reduced levels of postsurgical pain or discomfort and a more rapid return to physical activity and a normal daily routine. Depending on your circumstances, you may undergo XLIF as part of surgical treatment for disorders such as degenerative disc disease, recurring herniated discs, scoliosis, stenosis and spondylolisthesis.

Risks of the Procedure

Extreme lateral interbody fusion is a relatively new technique, and doctors don’t have much information on the intermediate or long-term outcomes of the procedure. While minimally-invasive surgeries typically come with lower levels of risk than more traditional surgeries, all forms of back surgery come with the potential for certain complications. Known potential complications associated with XLIF include infections, ongoing pain in the aftermath of the procedure, lack of proper fusion in your spinal column, damage to your spinal cord or nerves, damage to your blood vessels, a dangerous type of blood clotting called deep vein thrombosis, worsening of your original spinal problems, weakened muscles, pneumonia, urinary tract infections and the onset of a stroke.

 

References
American Academy of Orthopaedic Surgeons: Extreme Lateral Interbody Fusion – XLIF
“Journal of Neurosurgical Review”: Current Trends in Minimally Invasive Spinal Surgery
Spine-Health: XLIF – Lumbar Spinal Fusion
Spine-Health: XLIF Potential Risks and Complications
“Journal of Spinal Disorders & Techniques”: Extreme Lateral Interbody Fusion Approach for Isolated Thoracic and Thoracolumbar Spine Diseases – Initial Clinical Experience and Early Outcomes