Early complications of extreme lateral interbody fusion in. Extreme lateral interbody fusions xlif and minimally invasive mis xlif were developed to limit the vascular injuries associated with anterior lumbar interbody fusion alif, and minimize the muscular soft tissue trauma attributed to transforaminal lumbar interbody fusion tlif, posterior lumbar interbody fusion plif, and posterolateral lumbar fusion plf. Instability can be due to degenerated discs andor facet joints that. Extreme lateral interbody fusion for thoracic and thoracolumbar. The xlif extreme lateral interbody fusion is an approach to spinal fusion in which the surgeon accesses the intervertebral disc space and fuses the lumbar spine low back using a surgical approach from the side lateral rather than from the front anterior or the back posterior. Pdf minimally invasive extreme lateral lumbar interbody. In the last decade, lateral lumbar interbody fusion llif has gained in. Standalone interbody or lateral interbody fusion for. Lateral interbody fusion lif is traditionally performed with the patient in lateral decubitus, requiring repositioning to prone for adjunctive posterior procedures, or modifying traditional posterior techniques to be done while positioned lateral. Unauth abstract anterior and posterior approaches for lumbar interbody fusion can be associated with a number of. Extreme lateral interbody fusion xlif back in control. Extreme lateral interbody fusion or xlif19,23,24 is a 90degree o. In pinal fusion, two or more bones of the spine are painful motion,decompress pinched. In recent years, two major approaches of lumbar lateral interbody fusion llif have been popularized to offer more minimally invasive alternatives.
This study evaluates the results of inter body distraction. The extreme lateral interbody fusion xlif technique is a minimally disruptive surgical procedure performed through the side of the body. It is not meant to replace any personal conversations that you might wish to have with your physician or other member of your healthcare team. High neurological complication rates for extreme lateral lumbar interbody fusion and related techniques. The extreme lateral interbody fusion xlif method is a minimal invasive technique and a valuable alternative to the wellknown traditional standard techniques tlif, alif, plif for the operative treatment of degenerative lumbar spine diseases like degenerative scoliosis and degenerative disc disease 14. The damaged disc is space overview sionis a minimally invasive sc problems in the low back. Spine volume 35, number 26s, pp s331s337 2010, lippincott. Lateral interbody fusion has a similar if not lower rate of complications compared to traditional anterior and posterior approaches to interbody fusion. A novel surgical technique for anterior lumbar interbody fusion spine j, 6 2006, pp. You will be positioned on either your right or left side after you have had your general anesthesia. During lateral fusion, an incision is made at the side of the waist. In comparison with alif, the lateral approach does not risk. This incision may be directly over the level of your spine, which.
Retractor time was measured from the time the retractor was docked to the. Extreme lateral interbody fusion the spine journal. Major complications in extreme lateral interbody fusion. A lateral approach is made safe with the use of nerve monitoring. There is a new cage or interbody device technology for interbody fusion. Lateral including extreme, extra and direct lateral.
This booklet is designed to inform you about the extreme lateral interbody fusion xlif corpectomy surgical procedure. A corpectomy with corpus meaning body, and ectomy meaning remove is an effective procedure where the vertebral body and the adjoining discs are removed. Major factors prompted the development of minimally invasive mis extreme lateral interbody fusion xlif. Minimally invasive extreme lateral interbody fusion xlif is commonly performed for the treatment of degenerative disc disease with associated radiculopathy, spondylolisthesis, and scoliosis. See coding clinic 2 nd quarter 2009 pages 3 to 4 spinal fusion procedures the extreme lateral interbody fusion xlif is an innovative less. It is designed to treat a range of spinal pathologies. Transforaminal lumbar interbody fusion tlif incision made through a midline incision in the back. Complications and radiographic correction in adult. The 3d spinal alignment was improved with use of extreme lateral interbody fusion at multiple levels, augmented by a posterior lumbar fusion. While advances in minimally invasive spine surgery have popularized the lateral transpsoas lumbar interbody fusion ltif through a. A single skin incision, cm long, was performed on the right abdominal side with the midpoint above l4.
Dec 29, 2020 each patient underwent an extreme lateral interbody fusion nuvasive, inc. Home care instructions anterior lumbar interbody fusion alif. Extreme lateral interbody fusion for thoracic and thoracolumbar disease. This technique provides excellent access for anterior interbody fusion, while reducing approachrelated morbidity and eliminating the need for an. Lumbar lateral interbody fusion llif has grown in popularity and been adapted since then mainly through customised retractors and implants but it must also be recognised that there has been a large push. Direct, oblique, and extreme lateral interbody fusions dlif, olif, xlif are similar surgical procedures with slightly different names that approach the thoracic and lumbar spine from the flank region with smaller incisions. The rapid increase in the use of this approach in either primary or revision surgeries is related to its several advantages including less operative time, less blood loss and reduced length of hospital stay with fast recovery. The literature were analyzed for radiographic and clinical outcomes including neurological outcomes, fusion rate. The extreme lateral interbody fusion xlif corpectomy technique is a minimally disruptive surgical procedure performed through the side of the body.
Posterior lumbar interbody fusion techniques have been popular since the 1950. Lumbar interbody fusion lif is a common approach for the treatment of degenerative and instabilityinducing conditions of the spine. The keywords xlif, extreme lateral approach lumbar spine, lateral approach lumbar interbody fusion, olif, oblique lumbar interbody fusion were used to search for relevant articles. John otoole associate professor of neurosurgery rush university medical center 1725 w harrison street, suite 855, chicago, il 60612 figure 1. Dlif, xlif, transpsoas interbody procedure description code modifier comments arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace other than for decompression. The graft or device is then impacted into place, giving it as firm a fit as possible. Surgical technique during the surgery, the patient is placed in the side position and the table is bent to provide the surgeon with a maximum view of the spine. Anterior lumbar interbody fusion alif, transforaminal lumbar interbody fusion tlif, lateral lumbar interbody fusion llif, or extreme lateral interbody spinal fusion xlif with or without posterior instrumentation you are recovering from an alif, llif, tlif andor xlif spinal fusion.
This booklet is designed to inform you about the extreme lateral. As described previously, 10 the retractor was docked at the l45 disk interspace at the midpoint on the anteroposterior ap line of the inferior vertebra. Dynamically evoked, discretethreshold electromyography in. High neurological complication rates for extreme lateral. Multilevel extreme lateral interbody fusion xlif and. Larger surface area for fusion better endplate preparation larger graft placement for disc height restoration and lordosis with a good access surgical team, the complications associated with alif are minimal extreme lateral interbody fusion is a relatively new procedure. Microendoscopyassisted extraforaminal lumbar interbody. Anterior alif posterior plif transforaminal tlif extreme lateral xlif direct lateral dlif paraaxial axialif. If the procedure is not 22558, you must select not applicable. In the usual transpsoas interbody lumbar fusion, the size of the graft or interbody device is carefully matched to fit into the space between your vertebrae.
The extreme lateral interbody fusion xlif procedure has been described as an alternative approach to anterior column stabilization in degenerative, deformity. The extreme lateral approach offers several advantages over traditional interbody approaches. An incision is made though the skin down to your abdominal muscles. Pdf extreme lateral interbody fusion xlif researchgate.
Extreme lateral interbody fusion xlif was introduced as a minimally disruptive alternative to the anterior approach, allowing for the insertion of a largefootprint interbody cage through transpsoas retroperitoneal access 1, 2. In the usa, the volume of lumbar fusion increased by 62. Pdf anterior and posterior approaches for lumbar interbody fusion can be associated with a number of serious complications. The lateral approach is often referred to as extreme lateral or direct lateral interbody fusion xlif or dlif. Lumbar interbody fusion is a surgical technique that attempts to eliminate instability in the back. Xlif has become a popular surgical technique and an alternative method for conventional anterior and posterior approaches for interbody fusion 1. The benefits of lateral anterior column access may be achievable with the patient prone, allowing for concomitant posterior techniques in a more. Extreme lateral interbody fusion xlif print this letter. Original article extreme lateral interbody fusion for thoracic and thoracolumbar disease.
Extreme lateral interbody fusion is a relatively new procedure. Extreme lateral interbody fusion xlif was introduced as a minimally disruptive alternative to the anterior approach, allowing for the insertion of a large. In the last decade, lateral lumbar interbody fusion llif has gained in popularity. Transforaminal lumbar interbody fusion tlif incision made through a midline incision in. The advent of extreme lateral interbody fusion xlif approach, allowing the access to the anterior lumbar spine through a small lateral skin. An unrecognized complication after extreme lateral interbody fusion xlif. Initial multicentre clinical experience with prone. Extreme lateral interbody fusion xlif overview of the operation you will be positioned on either your right or left side after you have had your general anesthesia.
The patient was placed in a true 90 lateral decubitus position. This allows the implant to be delivered without manipulating the spinal cord or. The anterior and posterior longitudinal ligaments are left intact to provide stability to the disc space but good disc clearance is achievable. Nuvasive, san diego, ca, united states, has been introduced. Osteoamp case report lateral lumbar interbody fusion. The surgical goal is to relieve pressure on the nerve roots or the spinal cord, to treat a painful disc, or fix extreme. Not all the information here will apply to your individual treatment or its outcome. Extreme lateral interbody fusion xlif incision made in the patients side. Extreme lateral interbody fusion xlif san antonio, tx. Caring for myself after extreme lateral lumbar spinal fusion 5 change your positions often. Fusion 101 cheat sheet for medical coders medpartners. The arrow indicates narrowing of the disc space between l4 and l5. As surgeons become more proficient in the operation and as surgical technique is refined, sensory dysesthesias and psoas trauma associated with the procedure are becoming less prevalent.
Caring for myself after extreme lateral lumbar spinal fusion. Complications and radiographic correction in adult scoliosis. Avoid lying down, standing or sitting for long periods during the day. Xlif maintains a theoretical advantage over anterior, posterior, and transforaminal approaches by preserving the. For the procedure of 22558, minimally invasive lumbar interbody fusion, please select the technique that will be used for this surgery. Review of risks and complications of extreme lateral. Cureus using an extreme lateral interbody fusion xlif. Extreme lateral interbody fusion xlif is a relatively new technique whereby access to the disc space is achieved through a minimally invasive lateral, retroperitoneal, transpsoas approach. The extreme lateral approach extreme lateral interbody fusion xlif is described in a stepwise manner.
However, lateral interbody fusion has unique complications that include transient neurologic symptoms, motor deficits, and neural injuries that range from 1 to 60% in the literature. Nonneurological major complications of extreme lateral and related lumbar interbody fusion techniques. A radiographic assessment of the ability of the extreme lateral. Preoperative anteroposterior lumbar spine xray at l45. Because the psoas muscle, which contains nerves of the lumbar plexus, is traversed during the extreme lateral interbody fusion xlif approach, appropriate nerve monitoring is needed to avoid nerve injury during surgery and prevent approachrelated neural deficit. The traditional xlif approach requires no bone or ligament to be removed. Fusion of the l5s1 segment in degenerative lumbar spine. Complications associated with minimally invasive extreme. Xlif provides a safe approach that does not include the risk of abdominal and vascular complications that exists with the anterior approach. Name of policy minimally invasive lumbar interbody fusion. Oct 07, 2020 extreme lateral interbody fusion xlif is a relatively new technique whereby access to the disc space is achieved through a minimally invasive lateral, retroperitoneal, transpsoas approach. If you have a lot of discomfort in your back, you can use ice to help. This incision may be directly over the level of your spine, which needs to be fused. Using nerve monitoring technology, the surgeon gains lateral side access.
Clinical evaluation of microendoscopyassisted oblique. Major complications in extreme lateral interbody fusion access. The name of the procedure is derived from lateral from the side, interbody implants or bone graft placed between two vertebral bodies and fusion spinal stabilization. The authors provide a detailed description of the surgically relevant. Radiological and clinical outcomes following extreme. If you do any activity that increases your pain, stop it immediately. One of these approaches is the extreme lateral interbody fusion xlif procedure, which provides access to the lumbar spine using a true lateral approach 11. Minimally invasive techniques have gained popularity in spine surgery in recent years.
Extreme lateral interbody fusion xlif is one of these techniques. Extreme lateral interbody fusion xlif in the thoracic and thoracolumbar spine. Direct lateral interbody fusion dlif incision made in the patients side. Cureus using an extreme lateral interbody fusion xlif in. Extreme lateral lumbar interbody fusion xlif in the. Interbody fusion grafts were placed at the l2s1 followed by a percutaneous pedicle screw fixation at the same levels. Nerve injury and recovery after lateral lumbar interbody fusion with and without bone morphogenetic protein2 augmentation.
1775 1696 53 884 563 41 117 882 1290 1733 549 997 1765 249 902 1522 1746 436 1022 395 190 918 1689 174 661 207 473 568 434 1820 1789 1621 432 575 1454 1650 692