Lateral Lumbar Interbody Fusion (LLIF/XLIF)
What is a minimally invasive surgical lateral lumbar interbody fusion?
If you have advanced degeneration of the spine from arthritis and degenerative disc disease, you may be a candidate for the minimally invasive surgical lateral lumbar interbody fusion (LLIF/XLIF) surgical procedure.
Entering from the side (lateral) rather than the front (anterior) or back (posterior) avoids operating around the muscles that stabilize the spinal column.
During MIS LLIF, a small incision is made in the side of the patient. The spinal disc is removed and replaced with a spacer containing bone graft, which allows the two bones (vertebrae) adjacent to the replaced disc to fuse together. Screws and plates/rods may be used to hold the bones in place while healing occurs.
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What is minimally invasive spine surgery?
Minimally invasive surgical (MIS) procedures of the spine include the following benefits:
- Shorter recovery time
- Less post-operative pain
- Decreased blood loss
- Less damage to tissues and muscles
- Smaller scars
- Quicker return to daily activities
Who is a candidate?
LLIF/XLIF may be recommended to treat spine problems, such as advanced degeneration. However, only after conservative measures have failed to relieve symptoms will surgery be considered. Common problems treated with MIS LLIF are:
- Degenerative Disc Disease – Age and wear and tear can cause the discs that act as cushions between each vertebrae to shrink, resulting in abnormal movement. This abnormal movement can again result in an unstable area in the spine and compress the nerves, causing leg pain and numbness.
- Arthritis – Arthritis of the spine can lead to spinal stenosis. This is a narrowing of the spinal canal caused by bony spurs forming on the vertebrae, narrowing the opening through which the nerves and nerve roots must travel. This narrowing can cause pressure on the nerves, resulting in pain, numbness, tingling or weakness down the legs.
- Spondylolisthesis – This term describes a particular type of abnormal movement of the vertebrae. With spondylolisthesis, one vertebra has slipped forward over another causing leg pain, numbness, tingling and/or weakness.
- Scoliosis – This occurs when the combination of age and deterioration of the spine leads to the development of a curve in the spine. The combination of these changes causes the spine to lose its ability to maintain a normal shape.
Where does the bone for a fusion come from?
The bone graft can be taken from you or from a bone bank. If using your own bone, local bone is saved during the surgery. Bone from a bone bank is a good option, if your own bone is weak or damaged from osteoporosis. In addition, synthetic bone graft may be used.
How long will it take to recover?
Recovery time after MIS LLIF/ XLIF varies depending on your particular situation, the number of levels involved, and your general health. It can take up to three to four months for the bones to fuse together. Your doctor will give you specific instructions on activity levels, including when you can resume driving and working.