Extreme lateral lumbar interbody fusion (XLIF) is a relatively new alternative to traditional spinal fusion surgery. It is performed by accessing the spine through the side of the torso rather than the front or back. It is a minimally invasive procedure that can be used to treat several spinal disorders that cause chronic back or leg pain. When conservative treatments fail to yield the results you are looking for, lateral lumbar interbody fusion may be able to provide the relief that medication, physical therapy, and steroid injections were unable to.
The main benefit of accessing the spine through the patient’s side is that it makes it much easier to avoid major back muscles, bones, and ligaments. Plus, as a form of minimally invasive surgery, lateral lumbar interbody fusion sports a host of benefits, including:
- Swift Surgery: Lateral lumbar interbody fusion can be performed from start to finish in as little as one hour. Less time under the knife means equals a reduced chance of complications from surgery or anesthesia.
- Reduced Blood Loss: One of the main benefits of minimally invasive surgery is the use of smaller incisions that minimize blood loss. These smaller incisions also leave smaller scars than open surgeries.
- Less Pain: Unlike traditional or open surgeries, lateral lumbar interbody fusion doesn’t aggravate sensitive back muscles, bones, or ligaments. That means less pain after surgery. In fact, many patients are able to walk on their own power after the procedure.
- Shorter Hospitalization: Many patients can return to their homes the same day of surgery or after no longer than a single night in the hospital. In the past, patients would be forced to remain immobilized in a hospital bed for several days following surgery. Reducing hospitalization allows patients to recover in the comfort of their own home.
- Expedited Recovery Times: It’s possible to walk the very same day a patient undergoes surgery. Although a full recovery will take several months, there are far fewer impediments to one’s lifestyle than those recovering from traditional procedures.
How Is XLIF Surgery Performed?
Lateral lumbar interbody fusion begins with a one-inch incision on the side of the waist. The neurosurgeon enters the incision and removes the damaged disc. Then, the empty space that remains is filled with a bone graft. This bone graft acts as a spacer that resets the bones in the spine to their correct position. Once these bones are properly positioned, it will relieve compression on the spinal nerves and help relieve the patient of their symptoms. The bone graft facilitates fusion between the two bones. It can be reinforced with a plate and screws or pedicle screws to prevent re-injury. Bone cells form around the graft as a natural part of the healing process and, after three to six months, fuses the vertebrae into a single piece of solid bone.
The high success rate of this surgery is due to a number of factors. First, this neurological procedure utilizes dilation tubes to facilitate superior access to the surgical site. In doing so, they can avoid aggravating the muscles in the back and the abdominal organs. Second, a nerve-monitoring probe helps the surgeon avoid injuring spinal nerves with ease. When performed in an outpatient setting, lateral lumbar interbody fusion is a same-day procedure. Keep in mind that the specific surgery used to eliminate your symptoms will depend on the nature of your injury. Your neurosurgeon may suggest a one-level or multi-level fusion. One-level fusions involve the joining of two bones. Multi-level fusions join more than two bones.
Who Is a Candidate for XLIF Surgery in Florida?
Individuals suffering from degenerative disc disease, low-grade spondylolisthesis, mild to moderate scoliosis, spinal stenosis, slipped discs or ruptured discs, recurrent herniation, herniated lumbar discs, or symptoms that have been unaffected by conservative treatments are candidates for later lumbar interbody fusion. Conversely, individuals with damaged disc at L5-S1, severe spondylolisthesis, severe scoliosis, or who have had past abdominal surgery in close proximity to the kidneys are not good candidates for lateral lumbar interbody fusion. Upon diagnosis, a neurosurgeon may deem a patient unsuitable for this surgery if they have any other issues that could prevent a successful fusion.
How to Prepare for XLIF Surgery?
Prior to surgery, your neurosurgeon will run a variety of tests (i.e., blood test, chest x-ray, electrocardiogram) to update their diagnosis and ensure that no significant changes to your condition have occurred. Follow your medical provider’s instructions closely the week leading up to surgery and don’t deviate as this could lead to an increased risk of complications. Stop taking non-steroidal anti-inflammatory medicines and blood thinners for at least one week before the date of your surgery. If you are taking any other medications, your medical provider will instruct you on what to do. Needless to say, you don’t want to drink or smoke in the days leading up to surgery either.
No eating or drinking after midnight the night before surgery. In the morning, you will be instructed to take a shower with antibacterial soap and wear loose, comfortable clothes. If you have been instructed to take any medicine prior to surgery, you will do so as instructed. Once you have been admitted, an anesthesiologist will administer the anesthesia and the surgery will begin. Believe it or not, you’ll be on the road to recovery in one to two hours.
What to Expect After Surgery?
After surgery, you’ll want to take care of your wound to prevent the onset of infection. Keep it clean and don’t expose it to dirt and debris. You should wash your hands whenever handling the incision and only wear clean clothes and use clean towels. If you’re a pet lover, you’ll have abstain from letting your fur babies sleep in the bed while your wound is still healing.
During the first six weeks following surgery, you will have to abide by a somewhat restricted lifestyle. No bending, twisting, lifting, strenuous activity, smoking, driving, or drinking alcohol. Take your medication, drink a lot of water, and eat foods that are high in fiber. Painful constipation is common after surgery, and you should call a doctor if your constipation doesn’t cease after a few days. If your recovery goes according to plan, you should be able to return to daily activities in as little as six weeks. Keep in close contact with your surgeon and don’t be afraid to voice your concerns if something feels off.
As with any surgery, there are inherent risks, though they are rare. Your provider will discuss these with you prior to surgery.
