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Extreme Lateral Interbody Fusion (XLIF)

Spinal fusion has been a successful method of treating many types of degenerative spinal problems. Conventional spinal surgery is often associated with long hospital stays, high blood loss at surgery, and prolonged periods of rehabilitation.

Newer methods of minimally invasive spinal surgery have brought tremendous advances. One of these procedures is the Extreme Lateral Interbody Fusion or XLIF procedure. With the XLIF, Dr. Greenwald can approach the spine in a minimally invasive way with very little disruption of surrounding tissues. One of the great advantages of the XLIF procedure is the ability to restore disc height in a far less invasive manner than the traditional fusion. The XLIF procedure has been effectively used in patients suffering from several types of spinal pathology including degenerative disc disease, spinal stenosis with or without spondylolisthesis and scoliosis.

The XLIF procedure employs a unique approach to the spine. A small incision is performed in the lateral flank region. Dissection is performed down through the retroperitoneum and a tubular retractor placed just above the disc space. With recent advances in neurologic monitoring capabilities, surgeons are able to safely navigate around the lumbar nerves in order to enter the disc space. The disc material is then removed. A spacer made of PEEK (polyethylene) is then inserted into the disc space. Dr. Greenwald monitors the position and correct placement of the spacer using real-time fluoroscopy in addition to the dynamic EMG monitoring. Following the placement of the XLIF cage, some patients may have a lateral plate place through the same incision or the Dr. Greenwald may choose to place posterior pedicle screws via minimally invasive techniques.

Patients typically are walking within a few hours of the XLIF procedure and are then discharged the next day. Typically, patients are back to work within approximately two weeks.

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