UPMC neurosurgeons perform XLIF, a minimally invasive spinal fusion surgery, at UPMC Presbyterian in Pittsburgh and other UPMC locations. Patients travel from many U.S. states and other countries for XLIF surgery with our experts.
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XLIF, or eXtreme Lateral Interbody Fusion, is a minimally invasive spinal fusion surgery. UPMC neurosurgeons offer this state-of-the-art surgery to treat many common spine problems.
In traditional spine surgery, the neurosurgeon makes an incision on the front or back of the body to reach the patient's spine. The neurosurgeon may need to cut or move delicate muscles, bones, ligaments, or nerves to reach the spine. This makes for a longer, more challenging recovery.
With XLIF, UPMC neurosurgeons reach the spine by making small incisions in the patient's side. There are no incisions in the chest or back. This means the neurosurgeon can avoid the sensitive structures of the chest and back.
Many patients are eligible for this innovative minimally invasive surgery. Your neurosurgeon may suggest XLIF if you have a variety of spinal and back conditions including:
In spinal fusion, neurosurgeons fuse together 2 or more vertebrae. The goal of spinal fusion is to relieve pain and restore spinal stability. That goal remains the same whether the surgeon uses XLIF or a traditional open incision.
The spinal fusion surgery accomplishes this by:
In XLIF, the neurosurgeon places a specialized metal “cage" between the spinal bones. The cage provides a framework to keep damaged vertebrae spaced consistently. The cage contains bone graft material.
Over time, the bone graft will cause the 2 vertebrae to fuse together. This maintains the original spacing between the vertebra while also helping to ensure that they don't compress any nerves.
Choosing any kind of spinal fusion is a big decision. Expect your medical team to try conservative therapy first. This includes:
If nonsurgical treatments don't give you enough relief, it may be time to consider surgery. Your surgeon will let you know if you are a good candidate for XLIF.
Your UPMC neurosurgeon will set aside time during your initial consultation to answer your questions. Plan on bringing a list of questions with you to your appointment. Write down the answers so you don't forget.
You may want to ask:
Your neurosurgeon will give you specific guidance on how to prepare for your XLIF surgery. Expect to need some preoperative testing. Plan on completing the preoperative testing at least a week before you have surgery.
Common preoperative tests include:
Stop taking aspirin, blood thinners, and anti-inflammatory medicines at least a week before surgery. Your surgeon will give you specific guidance about when to stop. You may also need to discontinue taking vitamins or other supplements.
Stop eating and drinking at least 8 hours before surgery. Your doctor may want you to take your medications that morning with a sip of water (no coffee, tea, or juice).
Your surgeon's office will give you day-of-surgery information at your preoperative visit. This includes:
You'll want to leave all valuables at home, and wear loose, comfortable clothing.
During XLIF surgery, the surgical team will position you on your side on the operating table. The neurosurgeon will make a small incision in your side near your waistline. This is how the neurosurgeon will access your vertebrae.
Many minimally invasive surgeries require the surgeon to rely on a camera to see the surgical site. With XLIF, the surgeon uses a special tool to pull back tissue and see the surgical site directly. This improves efficiency.
The surgeon will remove the damaged disc between the affected vertebrae. Once that space is clear, the surgeon will place an implant into the disc space.
The implant will stabilize the bones of the spine. The implant will also remove pressure on the spinal nerves by restoring the disc to its full height.
UPMC neurosurgeons can complete XLIF surgery in as little as an hour. In contrast, many traditional spinal fusion surgeries take several hours to complete.
UPMC neurosurgeons perform XLIF at a variety of locations.
One of the major advantages of XLIF surgery is that the smaller incisions mean the back muscles, bones, and ligaments stay intact. With less trauma to delicate tissues, it's reasonable to expect shorter recovery times.
For example, you will probably begin walking the day of surgery. And you may need only an overnight stay in the hospital. If you have your surgery at a UPMC Outpatient Center, plan on going home the same day.
Some patients get immediate symptom relief following XLIF surgery.
You will probably be able to return to normal activity in just 3 to 6 weeks. This is faster that with traditional spinal fusion surgery, where recovery takes several months.
Although relatively safe in the hands of a skilled neurosurgeon, XLIF surgery does involve some risks. Possible side effects include:
Other risks are common to all surgeries. These include:
It's also possible that XLIF surgery won't ease your symptoms or may need to be redone later.
Since XLIF is not a cosmetic surgery, your health insurance should cover it as long as your neurosurgeon indicates that it's medically necessary.
When Dolores needed surgery to correct a severe curve in her spine, she turned to the experts at UPMC to help her get back to being the active and energetic person she once was.
Read more »Visit UPMC's Find a Doctor page to start the process of learning whether you are a good candidate for XLIF surgery.
