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What is XLIF Surgery?

XLIF, or extreme lateral interbody fusion, is a minimally invasive approach to spinal fusion surgery in which the neurosurgeon accesses the spine from the side of the patient’s body.

Spinal fusion is performed to join together two or more bones of the spine, called vertebrae, eliminating movement between them. This is done by inserting a bone graft in between the two vertebrae and allowing the body to heal it over several months, much like it would heal a bone fracture.

Traditionally, neurosurgeons accessed the spine through the front of the body (anterior) or the back (posterior) when performing spinal fusion surgery. With the side (lateral) approach, the surgeon does not have to cut through major muscles in the back or abdomen. This approach has several benefits, including:

  • A shorter hospital stay
  • Less post-operative pain
  • Less time in surgery
  • Minimal blood loss

XLIF may also allow you to return to normal activities more quickly.

To access the spine from the side of the body, the neurosurgeon makes a small incision and inserts an instrument called a dilator between the side of the abdomen and the muscles covering the spine. The surgeon then uses a retractor to gently widen the opening in the muscle tissue, remove any damaged or defective disc material, and insert the bone graft. Electromyography (EMG) allows the surgeon to monitor the position of the surgical instruments in relation to the nerves.

What is Extreme Lateral Interbody Fusion (XLIF) used for?

XLIF surgery can be used to treat the following spinal conditions:

  • Degenerative disc disease with instability
  • Herniated disc
  • Low-grade spondylolisthesis, a condition in which one vertebra slips over another
  • Spinal deformities, such as scoliosis

Am I a good candidate for XLIF Surgery?

You may be a good candidate for XLIF if you have one of the conditions listed above and have already tried non-surgical treatments. The location of the vertebrae to be fused will determine which approach is best.

Having one of the previously listed conditions does not necessarily mean you will need XLIF. More conservative treatments such as physical therapy or pain medication may be effective. Extreme lateral interbody fusion changes the normal movement of the spine, which may accelerate wear and tear of the vertebral joints adjacent to the fused vertebrae.

Medically Reviewed by Juan Uribe, MD on January 10, 2020