Extreme lateral interbody fusion (XLIF)

Extreme lateral interbody fusion (XLIF) is an advanced, minimally invasive spinal fusion procedure in which the surgeon accesses the spine from the side of the patient, rather than the front or the back. The disc in the front of the spine is removed and replaced with a stabilizing implant containing a bone graft. The two vertebrae are then fused together through the disc space. Because it avoids the major muscles of the back, this lateral approach offers a less disruptive surgical option for patients with chronic back pain.

Who is a good candidate for this procedure?

Potential candidates for XLIF are patients with pain or instability in the lumbar spine from disc degeneration, spondylolisthesis (where one vertebra has slipped forward over another), degenerative scoliosis (spine misalignment) or recurrent herniated disc. However, XLIF is not for everyone. For example,it cannot be used to treat conditions at the lowest level of the spine (L5-S1) because the pelvis prevents access.


The lumbar spine, or low back, includes the five largest and strongest vertebrae. Between each vertebra is a gel-like disc that provides a cushioning effect to absorb pressure and distribute stress. The low back is vulnerable to many pain-provoking disorders, ranging from simple strains to a herniated disc, degenerative disc disease, spondylolisthesis or spinal stenosis.

When is surgery recommended?

If you have worsening back or leg pain resulting from spondylolisthesis, disc degeneration, a chronic herniated disc or other spine abnormality that limits your everyday activities, and conservative measures failed, you could consider spinal fusion surgery.

The type of fusion surgery you have depends on many factors including your overall health, the location and severity of your problem, and your pain and disability. It is very important that you are carefully screened by a qualified surgeon who is trained in spinal fusion techniques to determine the best course of action.

What is the recovery time?

The XLIF procedure has many advantages that can lead to a faster recovery, including:

  • Reduced operative time
  • Less tissue damage and blood loss
  • Less post-operative pain
  • Minimal scarring
  • A shorter hospital stay

Patients are typically walking soon after surgery and require only one night in the hospital. Many patients who have XLIF surgery are able to return to normal activities in as little as six weeks. As with all surgical procedures, however, specific recovery time varies by patient and demand.

Surgeons who perform XLIF

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