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XLIF (eXtreme Lateral Interbody Fusion)

Symptoms: Impingement of nerves and fatigue of back muscles

xlif

XLIF

The XLIF® (eXtreme Lateral Interbody Fusion) procedure provides relief to patients who cannot tolerate a larger, open back surgery because of the increased risks of longer anesthesia time, blood loss, hospitalization, and recovery. It is also a less invasive alternative for patients who have lived with back or leg pain through years of various failed treatments, including steroid injections, physical therapy, and pain medication.

About Lateral Access Spine Surgery

Lateral access spine surgery is a safe and reproducible means of addressing certain spine disorders with an approach from the side of the patient, as opposed to an approach from the back or the front. A lateral approach is made safe with the use of nerve monitoring technology.

This approach does not require dissection or retraction of the sensitive back muscles, bones, ligaments, or nerves and allows for more complete disc removal and implant insertion as compared with traditional posterior procedures. As a result, operating time is

often reduced, patient blood loss is minimized, and recovery time is significantly shorter.

By allowing greater access to the disc space, a larger implant can be used, which indirectly decompresses nerves by restoring

disc height.

The XLIF Procedure

When performing XLIF back surgery, your surgeon will approach your spine from the side of your body. You will be positioned on your side on the surgical table and two small incisions will be made. One of the incisions will be made on your side – this is the incision from which most of the surgery will be performed. Another incision will be made slightly behind the first, toward your back.

After you have been positioned, an x-ray will be taken to help your doctor precisely locate the operative space. Next, your skin will be marked at the site where the two small incisions will be made. Your surgeon will use the latest instrumentation to access the spine in a minimally disruptive manner. Disc preparation is the next step. This is done by removing the disc tissue, an action which allows the bones to be fused together. Several x-rays will be taken during this stage to ensure the preparation is correct. Once the disc has been prepared, the surgeon will then place a stabilizing implant into the space to restore the disc height and enable the spine to once again support necessary loads. Once in position, a final x-ray will be taken to confirm correct implant placement. In the event that further stabilization is necessary, the surgeon may choose to insert additional screws, rods, or plates into the vertebrae.

The Advantages of a Lateral Approach

The XLIF procedure does not require entry through sensitive back muscles, bones, or ligaments, resulting in less postoperative pain. It also allows for complete disc removal and implant insertion, compared with approaches from the back. When compared to ALIF, where the surgeon enters from the front, the XLIF procedure offers the benefit of reducing the risk of vascular injury during the procedure.

Reduced operative time – Traditional procedures can take up to 5 hours; the XLIF procedure can be successfully completed in as little as one hour, reducing the amount of anesthesia time.
Reduced blood loss and minimal scarring – Less-invasive procedure allows for less tissue disruption, resulting in reduced blood loss.
Reduced postoperative pain – The XLIF procedure does not require entry through sensitive back muscles, bones, or ligaments. Many patients are usually walking the same day after surgery.
Reduced hospital stay – Patients are typically walking the same day after surgery and require only an overnight stay in the hospital, compared to several days of immobility and hospitalization typical of traditional open approaches
Rapid return to normal activity – Patients are usually walking the same day after surgery. Recovery is typically around 6 weeks, compared to 6 months or more.

	XLIF	MAS TLIF
Surgical Time	70-90 minutes	2-4 Hours
Blood Loss	<100 cc	100 - 200 cc
Patient Recovery (ambulatory)	7-12 hours	12 hours
Hospitalization	23 hours	1-2 days

Proven Results

The NVJJB/M5 System has been used successfully in over 70,000 spinal surgeries. With the minimally invasive XLIF® approach, and the safety afforded by this nerve monitoring system, you can experience a faster recovery from back surgery and a quicker return to your normal lifestyle.