NEUROSURGERY ARTICLES

EXTREME LATERAL INTERBODY FUSION

by Burak Ozgur, M.D.

Spinal surgery has come a long way. Not only have techniques improved, but our ability to diagnose and treat spinal disorders has evolved tremendously over the years. The spectrum of treatment options varies from decompression and fusion to the use of artificial discs and resorbable materials. Additionally, surgical corridors have evolved as well. We are now able to perform some of the same operations we would normally have done through smaller and less invasive incisions. This amounts to less blood loss, less postoperative pain, and shorter hospital stays.

One of these techniques is called the XLIF (extreme lateral interbody fusion). It is basically a technique in which we access the lumbar spine from a completely lateral approach (from the side). The main benefit in this approach is that this spares the patient from potentially having to have an approach through the abdomen which could run the risk of various complications. Additionally, this technique minimizes the disruption of muscles and other soft tissue and thus relates to less blood loss and postoperative pain. We find that following this operation, patients require less pain medication and are generally able to get out of bed, walk, and go home sooner than with the traditional abdominal approach.

The technique basically begins with the patient positioned on their side in the operating room. Then using intraoperative imaging and electrophysiologic monitoring, we are able to position a retractor which essentially opens a window for our operative corridor. Then a discectomy is performed in which disc material is removed. A graft or cage device is then positioned in place of the disc. Lastly, either a plate is positioned from the side or the patient is turned onto their abdomen and pedicle screws are placed in the back in order to hold the construct firmly in place.

This XLIF procedure can be performed in a single level or multiple levels depending on the patient's extent of spinal disease. We have found this technique to be a good tool in the spine surgeon's armamentarium to treat spinal disease. The XLIF is not right for everyone. However given the right indications, we have found it to significantly improve patient's outcomes both in patient's self evaluations and surgeon's evaluations of postoperative recovery and functional outcome.

University of California, Irvine • Irvine, CA 92697
(949) 824-5011
© 2006 The Regents of the University of California.
All Rights Reserved.

Comments & Questions: Privacy & Legal Notice
Copyright Inquiries