What is XLIF Extreme Lateral Interbody Fusion?


XLIF is a minimally invasive interbody fusion technique accomplishing the same goals of lumbar interbody fusion that conventional posterior and anterior surgery offers. Over the past ten years, advances in spine technology are trending towards minimally invasive techniques. In 2003, the XLIF procedure was developed to access the spine for fusion with as little soft tissue disruption as possible. Using the extreme lateral interbody fusion (XLIF) technique, we now access the spine of the low back (T5-L5) from the patient’s side. XLIF provides a safe approach that does not include the risk of abdominal and vascular complications that exists with the anterior approach.

The XLIF procedure, performed under fluoroscopic imaging and electro-physiologic nerve monitoring, can be used to treat most spine degenerative conditions requiring fusion.



 Patients undergoing minimally invasive spine surgery are sidelined for a short time and have small incisional scars. Radiographic evidence of fusion bone healing suggests that complex spine procedures are now being accomplished through smaller incisions without many of the risks and restrictions of major open surgery.

XLIF is an approach from the side of the patient, as opposed to an approach from the back (posterior) or the front (anterior). XLIF is a less invasive alternative for patients who have lived with back or leg pain through failed treatments, including conservative measures such as steroid injections, and physical therapy as well as failed previous surgery. XLIF procedure includes the use of NeuroVision, an advanced nerve monitoring system (EMG) that allows the surgeon to have real-time feedback about nerve location, reducing the incidence of nerve injury during surgery.





Patient Benefits:

  • Reduced operative time –completed in as little as one hour.
  • Reduced blood loss and minimal scarring.
  • Reduced postoperative pain.
  • Reduced hospital stay may require only an overnight stay in the hospital.
  • Rapid return to normal activity Recovery is typically around 6 weeks.

Candidates for the XLIF procedure include those:

  • Suffering from degenerative disc disease with instability.
  • With recurrent disc herniation.
  • With instability after a previous non-fusion surgery.
  • Who require surgery to a disc adjacent to a previous surgery.
  • With a disc that has slipped over another (spondylolisthesis).
  • With degenerative scoliosis (curvature of the spine).
  • With prior fusion surgeries that did not fuse (pseudarthrosis).



Despite its advantages, The XLIF procedure is not recommended for:

  • Symptomatic L5–S1 level.
  • Those with severe spondylolisthesis (severe slip of one vertebra over another).
  • Internal abdominal scarring on both sides due to prior surgery.

XLIF Extreme Lateral Interbody Fusion

Many complex disorders and injuries of the spine that once required large incisions and long months of inactivity and recovery can now be corrected with San Antonio minimally invasive techniques with less muscle disruption, dramatically reduced blood loss, and early discharge home in days with minimal discomfort and lifestyle disruption.

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