Minimally invasive surgery mis consisting of extreme lateral interbody fusion procedures xlif were devised to afford maximal disc excision and end plate availability for interbody fusion, while providing indirect decompression of the neural elements. Major factors prompted the development of minimally invasive mis extreme lateral interbody fusion xlif. Extreme lateral interbody fusion leeds spine clinic spine. The advantage of llif over the traditional anterior approach is the avoidance of exposure of the abdominal viscera, large vessels, and sympathetic plexus. This incision may be directly over the level of your spine, which needs to be fused.
An incision is made though the skin down to your abdominal muscles. In spinal fusion, two or more bones of the spine are joined to stop painful motion, decompress pinched nerves, and correct scoliosis. Extreme lateral interbody fusion xlif san antonio, tx. Early complications of extreme lateral interbody fusion in. It is designed to treat a range of spinal pathologies. Spine surgery that helps the body heal itself piedmont. Prone singleposition extreme lateral interbody fusion proxlif. The xlif extreme lateral interbody fusion is an approach to spinal fusion in which the surgeon accesses the intervertebral disc space and fuses the lumbar spine low back using a surgical approach from the side lateral rather than from the front anterior or the back posterior. Xlif is a minimally invasive interbody fusion technique accomplishing the same goals of lumbar interbody. Disc material is removed and a fusion graft is placed into the disc space. These include providing interbody stabilization and indirect neural decompression. The extreme lateral interbody fusion xlif is a useful procedure for a number of conditions that require fusion of the lumbar spine such as degenerative conditions, instability, and deformity of the lumbar spine.
Xlif is simply a term given to an interbody fusion procedure where the spine is accessed from the patients side laterally. Extreme lateral interbody fusion xlif is a minimallyinvasive surgery that involves the fusing of two degenerative spinal vertebrae. An interbody fusion is a method of fusing the lumbar spine that involves removing the damaged intervertebral disk. One of the most common procedures that i book patients for is an extreme lateral interbody fusion xlif.
The aim of this study is to determine the fusion rate of inter body fusion using computed tomography in patients treated by extreme lateral intersomatic fusion xlif technique. Xlif extreme lateral interbody fusion and dlif direct lateral interbody fusion both use small incisions on the side lateral of the body to access the spine, and thus can only be used for vertebra that can be reached from the side. Extreme lateral interbody fusion xlif texas back institute. Extreme lumbar interbody fusion xlif or direct lateral interbody fusion dlif is a surgical procedure indicated in various spine conditions. Extreme lateral interbody fusion xlif is a minimally invasive procedure for reducing longterm neck or back pain, generally caused by degenerative disc disease. Clinical outcome and fusion rates after the first 30 extreme lateral. Extreme lateral interbody fusion xlif is a surgical procedure in which the front part of the lumbar spine is fused from the side. A lateral approach is made safe with the use of nerve. Covering both minimally invasive and open procedures, this comprehensive reference provides stepbystep details for proven techniques, including extreme lateral, oblique lateral. The patient is supine, instrumentation and implants go through the anterior of the body and directly into the anterior vertebral column. It is often called the transpsoas approach because in the lumbar spine, it requires traversing the psoas muscle. Extreme lateral interbody fusion xlif is a minimally disruptive surgical technique in which the surgeon approaches the spine from the side of the patients body, rather than the front or back as in traditional spine surgeries. These include providing interbody stabilization and indirect neural decompression while avoiding major visceralvessel injury as seen with anterior lumbar interbody fusion alif, and to avert trauma to paraspinal.
It can be performed at multiple lumbar levels although. The xlif extreme lateral interbody fusion is an approach to spinal fusion in which the surgeon accesses the intervertebral disc space and fuses the lumbar spine low back. Piedmont offers several minimally invasive spinal fusion procedures. Lateral lumbar interbody fusion is a minimally invasive technique first described by ozgur et al. Lateral approaches to interbody fusion musculoskeletal key. Like any other surgical approach to the spine there are advantages, limitations and risks to an xlif procedure. Using patented nerve monitoring technology, the surgeon gains lateral side access to the spinal column, avoiding any major nerves in the area between. Pdf extreme lateral interbody fusion in spinal revision surgery.
The advantage of extreme lateral interbody fusion is that it is a less invasive procedure that allows rapid mobilization of the patient. Extreme lateral interbody fusion xlif radiology reference article. Lateral lumbar interbody fusion back pain centers of america. The extreme lateral approach extreme lateral interbody fusion xlif is described in a stepwise manner. Extreme lateral interbody fusion arlington chronic back. Extreme lateral interbody fusion, often shortened to just xlif, is a minimally invasive procedure that aims to help reduce longterm back pain and spinal disorders. Alif anterior lumber interbody fusion is clearly anterior approach. In a tlif, rather than starting from the center and stripping the back muscles outward, the surgical approach starts at an angle to the spine and bluntly separates rather than cuts back muscles on just one side. The surgeon inserts a probe and guides surgical instruments in the incision.
In a lateral lumbar interbody fusion, the surgeon accesses the spine through incisions in the side, rather than the front or back. Extreme lateral interbody fusion xlif is a form of lumbar surgical spinal fusion developed in 2001 to be a safer alternative to the older anterior lumbar interbody. Anterior lumbar interbody fusion in san francisco alif. Lumbar spinal fusion pcs approaches healthcare resource. Fusion means that we are joining segments of the spine together, he explains. The lateral transpsoas approach for anterior lumbar interbody fusion extreme. Anterior and posterior approaches for lumbar interbody fusion can be associated. Review of risks and complications of extreme lateral interbody fusion xlif. While youre preparing to talk to your physician more about your procedure, here is some general information about what to expect after an extreme lateral interbody fusion xlif procedure.
Lateral interbody fusion in the lumbar spine for low back pain. Changes in spinal alignment following extreme lateral interbody. Review of risks and complications of extreme lateral interbody. Extreme lateral interbody fusion procedure demonstrated sequentially. Oblique lumbar interbody fusion during the last 20 years several lessinvasive anterior approaches to the lumbar spine have become standard, including the extreme lateral lumbar interbody fusion.
Lateral lumbar interbody fusion xlif is a minimallyinvasive procedure used to treat leg or back pain generally caused by degenerative disc disease. What is transforaminal lumbar interbody fusion tlif. Lumbar interbody fusion lif surgery is a surgical technique that involves the removal of a damaged intervertebral disc and the insertion of a bone graft into the disc space created between the two adjoining vertebrae. Although it is associated with a lower risk of vascular injury compared with anterior midline approaches, neuromonitoring is considered mandatory to avoid neurologic complications. Fusion rate following extreme lateral lumbar interbody fusion. Volcan editor see all formats and editions hide other formats and editions. Schematic drawing showing a the surgeons index finger inserted into the paraspinal incision site, b identifying the retroperitoneal space, and c guiding the initial dilator into position. Extreme lateral interbody fusion xlif you will be positioned on either your right or left side after you have had your general anesthesia. The technique allows for robust fusion while avoiding many of the complications associated with more traditional anterior and posterior approaches. The traditional xlif approach requires no bone or ligament to be removed. Extreme lateral interbody fusion xlif extreme lateral interbody fusion xlif is a minimally invasive procedure performed through the side of the body to access the spinal disorders, rather than from the front or back and sparing major back muscles, bones and ligaments. Accepted manuscript manuscripts that have been selected for publication. Spine extreme lateral interbody fusion xlif neurodiagnostics. This study examined the ability of the extreme lateral interbody fusion xlif.
Lateral interbody fusion is a minimally invasive surgery to treat disc problems in the low back. Surgical technique 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. This is a minimallyinvasive lumbar fusion procedure that has all of the benefits of the classic anterior lumbar interbody fusion alif without its downsides all of the bad things that can occur by traversing someones abdomen to. Xlif extreme lateral interbody fusion portland spinal. Minimally invasive spine surgery washington dc spine surgery. Tim yoon definition lateral approach to interbody fusion many different names including extreme lateral interbody fusion xlif, direct lateral interbody fusion dlif, or oblique lumbar interbody fusion olif. Authored by experienced surgeons and key innovators in the fastmoving field of lif surgery, lumbar interbody fusions provides an indepth, focused approach to recent advances in surgical techniques and technology. They have not been typeset and the text may change before final. Extreme lateral interbody fusion leeds spine clinic. The lateral lumbar interbody fusion llif is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. Unlike traditional surgical procedures that take place in the spine, the incision is made on the side rather than the back or front.
Over the past several years interbody fusion has evolved a great deal. The lateral lumbar interbody fusion llif is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the. Patients ask us all the time, what can i expect after my surgery. The procedure is performed through two small incisions in the patients side, avoiding and sparing the major muscles of the back, as well as ligaments and bones. Extreme lateral interbody fusion xlif is a relatively new tech nique whereby. Posterolateral interbody fusion plif transforaminal lumbar interbody fusion tlif extreme lateral interbody fusion xlif anterior lumbar interbody fusion alif recovery and prognosis. One of the newest spinal fusion techniques is extreme lateral interbody fusion, or xlif.
Image of md explaining extreme lateral interbody fusion xlif procedure extreme lateral interbody fusion xlif extreme lateral interbody fusion xlif can be helpful for those with chronic low back pain. This allows the implant to be delivered without manipulating the spinal cord or the great vessels. Extreme lateral interbody fusion innovative spine md. Lumbar interbody fusion what is lumbar interbody fusion. Coding xlif l34 and l45 with facet fusion l34 and l45 with allograft. Llif allows the surgeon to access the intervertebral space via a minimally invasive direct lateral approach through the psoas muscle. Data for other mis anterior lumbar interbody fusion alif and extreme lateral interbody fusion xlif series further demonstrated even higher and more unacceptable frequencies of radiculitis andor. Some of the conditions where xlif is performed include disc degenerative disease, recurrent disc herniation, degenerative spondylolisthesis, degenerative scoliosis, and pseudoarthrosis. Lateral lumbar interbody fusion llif is an increasingly common arthrodesis strategy. Extreme lateral interbody fusion xlif hardcover 20 by j. Transforaminal lumbar interbody fusion san antonio, tx. Low back pain is a common condition that occurs in a significant portion of the population at.
Lateral approaches include xlif extreme lateral interbody fusion and dlif direct lateral interbody fusion. The procedure is performed through the patients side, avoiding the major muscles of the back. Presented during the 2009 aans annual meeting as part of the aans international symposium. Extreme lateral interbody fusion xlif back in control. It does have very high fusion rate and excellent postoperative outcomes. Extreme lateral interbody fusion xlif spine surgery. The surgeon makes an incision in the side between the lower ribs and the pelvis.