What is a Far Lateral Interbody Fusion (XLIF/DLIF)?

As a lower back surgeon, Dr. Braxton performs far lateral interbody fusion for patients with certain spinal conditions. There are several types of lumbar interbody fusion surgeries that can be performed from different surgical approaches. In the case of the far lateral interbody fusion, Dr. Braxton utilizes a side-of-the-body approach to reach the spinal level to be treated centering the entry incision on the patient’s flank toward the spine.

When the far lateral approach is recommended, the patient has the benefit of minimized surgical impact on the body. This approach avoids dissecting muscle, blood vessels and organs as well as the need to move spinal nerves out of the way. Once at the disc, the repair and fusion process is similar to other interbody fusion procedures with a goal of repairing the disc, normalizing the disc space and stabilizing the spine. The far lateral approach is also referred to as a direct lateral interbody fusion (DLIF) or an extreme lateral interbody fusion (XLIF).

What is the XLIF/DLIF Procedure?

The directed lateral interbody fusion (DLIF) and extreme lateral interbody fusion (XLIF) are the same procedure. It is a surgical treatment for eligible patients with certain lumbar spinal conditions. In both cases, a directed lateral approach or an extreme lateral approach, the surgical entry location is from the patient’s side flank. This side approach technique is minimally invasive for optimal result. The disc is removed and replaced through the lateral approach. With this approach there is more room enabling the surgical spacers to provide extra stability compared to other traditional interbody fusion procedures. These larger spacers provide the added benefits of:

  • Increased stability
  • Restored disc space
  • Improved spinal alignment
  • Heightened rate of success

Dr. Braxton works closely with patients diagnosed with a range of lumbar spinal degenerative conditions, to evaluate eligibility for the direct, or extreme lateral interbody fusion procedure.

What does XLIF and DLIF Procedure Treat?

Dr. Braxton can provide an evaluation for far lateral interbody fusion surgery for patients diagnosed with the following lumbar spinal conditions:

  • Degenerative disc disease

  • Recurring lumbar disc herniation

  • Thoracic disc herniation

  • Degenerative scoliosis

  • Various spinal deformities

  • Disc height anomalies

  • Low grade spondylolisthesis

Disc repair or replacement, vertebrae normalization, and disc fusion techniques are required for the treatment of these and other lumbar spine conditions. Dr. Braxton provides an exhaustive patient evaluation in order to provide a recommendation for this advanced, minimally invasive treatment.

How is the XLIF and DLIF Procedure Performed?

Although the direct lateral interbody fusion and extreme lateral interbody fusion are minimally invasive, they are considered a major surgery and general anesthesia is used. The patient is placed on their side and a small incision is done on the exposed side approaching the spine. This procedure avoids dissecting soft tissue to create the surgical window. Once at the surgical site, damaged disc material is removed and the disc space is cleaned out. This often leaves a partial disc wall to help hold the bone graft material. The space is prepared for optimal alignment, the disc is replaced and the bone graft material and structure is implanted such that the healing process fuses the bone together into a solid stable form. Some patients may require further surgical instrumentation for optimal stability including plates, screws and rods. The incision is closed and the patient begins recovery.

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What is the Recovery Like After Far Lateral Interbody Fusion?

Dr. Braxton provides comprehensive patient education and realistic expectations for patients as well as careful monitoring during the recovery period. Typically, patients remain in the hospital three to five days. Pain management continues both in the hospital and at home. A physical therapy walking program begins the day after surgery. Comfort with standing, sitting, walking, climbing stairs, and getting in and out of bed begins during the recovery process.

It is important the patient attend all postoperative office visits for Dr. Braxton to monitor progress. Pain medication will gradually be reduced and anti-inflammatory medications may be recommended to ameliorate normal postoperative inflammation. Muscle relaxants may also be prescribed if muscle spasms occur around the surgical site. It is recommended that use of nicotine be avoided as it interferes with medications along with other drawbacks. Patient should be cognizant of the rate of healing for impacted nerves. A fully healed nerve can require weeks to months to resolve. Physical activity must be gradual beginning with small walks and increasing as tolerated. Extreme motion should be avoided, including twisting, lifting and bending, as well as vigorous household chores and activities during the initial recovery period. Good health habits of sleep, nutrition and hygiene help facilitate a quicker recovery. Dr. Braxton can answer all patient questions during the recovery process, including when to return to driving and work.

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