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- Lateral Lumbar Interbody Fusion
Minimally Invasive Spinal Fusion
A minimally invasive spinal fusion using an anterior approach is a procedure that allows a neurosurgeon to access the spine from the side rather than the back or front. Approaching the spine this way results in less disruption of muscles, blood vessels and nerves; less blood loss; reduced time in the operating room; decreased pain; often times a reduced hospital stay, and a faster recovery.
There are many reasons that a surgeon may choose to use a minimally invasive spinal fusion procedure to fuse the spine. This procedure has been used to treat a variety of spinal disorders that require spinal fusion, including:
• Spondylolisthesis
• Degenerative scoliosis
• Spinal deformities
• Adjacent segment disease
• Pseudoarthrosis
• Degenerative disc disease
• Foraminal stenosis requiring disc height restoration
• Recurrent lumbar disc herniations
• Thoracic disc herniations
With lateral fusion, patients are positioned on their side on a special surgical table that flexes down from the middle, exposing the patient's opposite side for surgery. Two incisions are made - one over the side of the waist through which most of the procedure is performed, and the other behind the first, through which the neurosurgeon's finger guides the instruments into a safe position.
As tubes are advanced past the muscle on the side of the vertebrae, X-rays and nerve monitoring help to guide the tubes to the correct location on the spine as well as avoid nerves. Nerve monitoring assists neurosurgeons with implant placement by monitoring nerve activity throughout the procedure.
The biggest concern coming through the side is going through the hip flexor muscle. When going through the hip flexor muscle, a neurosurgeon needs to avoid the nerves that are inside the muscle. Nerve monitoring allows the neurosurgeon to get to the spine safely, with minimal risk and disruption of supporting muscle tissue to the spine.
After the tubes are in place, the neurosurgeon removes the intervertebral disc between the two vertebrae and prepares the disc space for fusion. The neurosurgeon then places a stabilizing implant into the empty disc space to restore proper disc height and correct spinal alignment. Then the retractor is removed, X-rays are taken and the skin incisions are closed.
Because the procedure is less disruptive than conventional posterior or anterior surgery, most patients are able to get up and walk around within a day of the surgery.
For additional information on minimally invasive spinal fusion, please visit www.xlif.com and www.lateralaccess.org.