XLIF, or Extreme Lateral Interbody Fusion, is a minimally invasive approach used during spine surgery being performed to reduce back or leg pain that hasn’t gotten better with medications, injections or physical therapy.

What is XLIF Spine Fusion?

The surgeon enters the spinal column from the side, rather than the front or back, using small incisions and specialized instruments rather than open surgery. Your surgeon uses X-ray and EMG technology to split the muscles, avoid the nerves and remove the problem disc, before placing an implant filled with bone graft that will then fuse itself into place over time after surgery.

Who should have an XLIF Spine Fusion?

OrthoNebraska might recommend this procedure for anyone who hasn’t gotten the pain relief they are seeking from medications, physical therapy or injections. Depending on the cause of a patient’s pain, it can be used to treat many conditions that are the underlying cause of back or neck pain, including but not limited to:

  • Instability from previous surgery or other conditions
  • Spinal stenosis
  • Degenerative disc disease or facet arthritis
  • Scoliosis
  • Spondylolisthesis
  • Previous fusion surgeries that did not fuse correctly
  • Chronic or frequent herniated discs

The standard approach for spinal stenosis or pinched nerves includes traditional laminectomy to achieve a direct decompression. However, XLIF is often used to achieve an “indirect decompression” and – in specific situations – can be used in the case of pinched nerves or spinal stenosis. XLIF has the potential to eliminate the need to perform some direct decompression, or other procedures typically included during spinal decompression and fusion.

How well does XLIF Spine Fusion Work?

Research has indicated the success in terms of the fusion rate exceeds 90 percent. Despite successful fusion, some patients may experience ongoing pain secondary to surgery, or from other areas of the spine. A small number of patients with successful fusion do not experience significant pain relief – about 5 percent. Overall, about 85 percent of patients can be expected to have significant pain relief and report they are happy they had the procedure.

What can I expect when I get an XLIF Spine Fusion?

You will need a pre-surgical physical to make any necessary accommodations based on your health history and may need additional appointments with your cardiologist or pulmonologist if you have conditions that would impact this surgery. When you arrive at the hospital, you’ll speak to your surgeon and anesthesiologist. You are put to sleep (general anesthesia) and placed on your side for this operation.

Surgical treatment is highly individualized based on a patient’s specific symptoms and anatomy. Prior to your surgery, a detailed discussion will be held with your back surgeon to explain the XLIF procedure, and any additional components of your surgery that may be required based on symptoms and anatomy.

You can expect to spend one or two nights in the hospital. You should be able to walk the same day and will begin to resume some of your typical activities within a few weeks. Return to full activity can be expected following a healed fusion of the XLIF level, which requires several months. Most of the after care will be focused on local pain and tenderness.

Time off from work, depending on the physical nature of work, is approximately one week, but full recovery and the ability to do rigorous activity may take several months.