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. The XLIF procedure offers the benefit of reducing the risk of vascular injury during the procedure.

Some candidates for the XLIF procedure include those:

·       Degenerative disc disease with instability.

·       Recurrent disc herniation.

·       Instability of motion segment.

·       Adjacent to previous surgery.

·       Disc slip (spondylolisthesis).

·       Degenerative scoliosis

About Dr. Fogel

An Orthopaedic Spine Surgeon who specializes in the treatment of disorders of the spine in the renowned San Antonio Medical Center area. Dr. Fogel trained in orthopedic surgery at the Mayo Clinic. His Orthopedic Spine fellowship training was with the Baylor College of Medicine in Houston Texas. He has published more than fifteen scientific journal articles concerning disorders of the spine. He is certified by the American Board of Orthopedic Surgery.

Advantages of XLIF Approach

A successful alternative to traditional open spine surgery through gentle, minimally invasive procedures

Anterior approaches to the lumbar spine allow for the indirect decompression of the spinal canal and neural foramina by placement of a large interbody graft to reconstruct the anterior column.   A novel, minimally disruptive spine procedure called the extreme lateral interbody fusion or XLIF is a direct lateral approach that allows for large graft placement and excellent disc height restoration, and provides indirect decompression of the stenotic motion segment. Since the introduction of the XLIF technique to North America in 2003, a host of advantages for our patients have become apparent:

·        less tissue damage leads to quicker recovery and decreased narcotic requirements;

·        it is widely applicable to a host of degenerative spinal conditions; 

·        It is safe and reproducible with few complications due to the use of automated neuromonitoring (NeuroVision®);

·        the large, load-bearing interbody construct provides disc space distraction, indirect decompression, sagittal alignment correction, and stability;

·        improved efficiency resulting in shorter operating room (OR) time and decreased length of stay.

Minimally Invasive Anterior Fusion

XLIF–Extreme Lateral Interbody Fusion

Results of XLIF Fusion Surgery

·        Hospital stay  1-2 days

·        Blood loss  5-25 cc

·        Disc height doubled to 10mm

·        Spondylolisthesis improved 5mm

·        Scoliosis improved 17.9° to 9.7°

·        Pain:  8.3 improved to 2.4

·        Return Work 2 wks part time, 6 wks full  time

·        Fusion rate 96%

·        Good and Excellent Outcomes 92%

 Complications of XLIF Surgery

·        Transient thigh numbness 25%

·        weakness of the hip flexor 20%

·        slowed bowel function (Ileus) 6%

·        Radiculopathy 1%

XLIF