The XLIF® lateral approach is a recent innovative surgical technique for lumbar fusion that allows access to the spine through a lateral approach. This possibility allows access to the discs and vertebrae of the spine avoiding the problems and injuries of the anterior and posterior approaches, without the need to manipulate the muscles or nerves.
It is a technique widely used for the approach of an intervertebral arthrodesis or fusion and for the treatment of the following degenerative pathologies of the lumbar spine:
- Degenerative disc disease (DDD: degenerative disc disease).
- Canal and foraminal stenosis.
- Spondylolisthesis (vertebral displacements) both degenerative and other causes (traumatic, congenital, acquired, etc).
- Surgical revisions of previously failed surgeries.
- Adjacent segment pathology.
- Adult degenerative scoliosis, FBSS-failed back surgery syndrome and sagittal balance disorders.
How is it performed?
The patient lies in a lateral position so that a lateral abdominal incision can be made to access the abdominal wall musculature. Once this is done, the muscle fibers of the external oblique, internal oblique and transverse abdominis muscles are separated and the retroperitoneal space is accessed where the psoas muscle is identified. Finally, neurophysiological mapping is performed to identify the nerves that pass within the muscle and a retractor is placed to allow access to the intervertebral disc.
At this point, the diseased intervertebral disc is resected, the vertebral plates are cleaned, the cartilage is removed and the interbody is placed.
Advantages of the XLIF®
- Minimally invasive approach
- Recovery
- Reduced hospital stay
- Better results
Are there any risks during the procedure?
Possible complications may be related to the approach or to the arthrodesis and include:
- Bleeding
- Hematomas
- Superficial and/or deep infection
Injury to the abdominal wall musculature may also occur, which may cause a lump to appear on the abdominal wall, but rarely, in less than 1% of cases, damage to the lumbar nerve plexus may occur, causing nerve damage that weakens the strength of the leg. Therefore, we can affirm that it is a safe procedure.
Recovery and rehabilitation
A few days after the operation, a control X-ray is taken and after 4-5 days the patient is discharged. During the following days control visits and X-rays are performed to assess the state of the wounds and check the status of the fusion.
Depending on the evolution of the patient, within the following 3-6 months he/she can return to normal activities and begin to perform light physical exercise.