Threaded cylindrical cages made of titanium, cortical allograft donor bone or synthetic bone. Clinical benefits xlif is the only lateral approach procedure proven by over 10 years of clinical evidence. The better way back has a network of patient ambassadors who talk to patients considering the xlif procedure. The procedure, called xlif extreme lateral interbody fusion, involves a lateral, or side, approach to spine.
The extreme lateral interbody fusion xlif technique is a minimally disruptive surgical procedure performed through the side of the body. However, the tlif procedure places a single bone graft between. Proven results the nvjjbm5 system has been used successfully in over 70,000 spinal surgeries. This is in direct contradistinction to a typical transpsoas approach in which the upper hip is. The five primary interbody fusion approaches are shown here schematically. Description the osteomed spine primalok sp interspinous fusion system is intended to provide immobilization and stabilization of spinal segments as an adjunct to fusion of the thoracic, lumbar andor sacral spine. Minimally invasive extreme lateral transpsoas approach to. Information you read on this website cannot replace the relationship that you have with your healthcare professional. The xlif procedure is the first clinicallyvalidated lateral approach to the. The oblique lateral interbody fusion olif procedure provides spine surgeons with a complete minimally invasive solution for the treatment of degenerative lumbar conditions. Start studying xlif surgical technique study guide. As with all surgical procedures, the technique used in each case will depend on the surgeons medical judgment as to the best treatment for each. If applicable, specify the brand named device to be used.
Multilevel extreme lateral interbody fusion xlif and. Like the plif posterior lumbar interbody fusion procedure, bone graft is used to fuse the spinal vertebrae after the disc is removed. Extreme lateral interbody fusion xlif in the thoracic and. Alphabet soup or surgical treatments for the spine. Surgical technologist role of the surgical the surgical technologist handles the instruments, supplies, and equipment necessary during the surgical procedure. The oblique lateral interbody fusion olif procedure allows for minimally invasive retroperitoneal access to the lumbar spine for surgeons who want to address degenerative pathologies. Adam kanter, md, director of the minimally invasive spine program at upmc presbyterian, narrates a stepbystep video and animation of the xlif extreme lateral interbody fusion spine procedure. Surgical technique guide 2 acknowledgments stryker spine wishes to thank the following surgeons for their dedication and contributions to the development of the acculif expandable lumbar interbody fusion technology. Xlif procedure minimally disruptive procedure for spine surgery. Extreme lateral interbody fusion xlif is a relatively new tech nique whereby access to the disc space is achieved through a minimally invasive lateral, retroperitoneal, transpsoas approach.
The xlif technique is a minimally disruptive surgical procedure performed through the side of the body. Using nerve monitoring technology, the surgeon gains lateral side access. Particular attention is given to indications, surgical technique, advan tages, and potential complications of this approach in the surgical treatment of spinal. Llif is suitable for conditions that require access to the interbody disc space from t12l1 to l45. A spine fusion is a surgical technique that connects two bones of spine together with new bone. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Extreme lateral interbody fusion xlif the spine journal.
Xlif surgical technique guide surgical tech classes. A lumbar fusion refers to fusing two or more vertebrae in the low back. In searching for ways to improve patient care and reduce operative morbidity there have been many significant improvements in instru mentation and technique. Timberline lateral fusion system surgical technique guide. A transforaminal lumbar interbody fusion tlif is performed to remove a portion of a disc that is the source of back or leg pain. Lumbar fusion with the xlif technique preoperative information what is a lumbar fusion. Case report and discussion of surgical technique extreme lateral interbody fusion xlif. Xlif technique is a minimally disruptive surgical procedure performed through the side of the body. A lateral approach is made safe with the use of nerve. Setup place the patient on a radiolucent operating table in the supine position. If miniopen modified wiltse rod placement is desired, make a.
This publication is not intended for distribution in the usa. Aug 04, 2015 you can also talk with a patient whos had the xlif procedure. The system is designed to provide anterior spinal column support and. Oct 18, 2015 the llif or extreme lateral interbody fusion xlif technique was described by ozgur et al. Impacted cages made of titanium, carbonfiber reinforced or plain peek polymer polyetheretheketone. The tlif technique involves approaching the spine in a similar manner as the plif. The materials on this website are for your general educational information only. Extreme lateral interbody fusion xlif is an alternative to standard posterior approaches for achieving fusion in the lumbar spine. With the minimally invasive xlif approach, and the safety afforded by this nerve monitoring system. By utilizing an oblique lateral approach to the spine, this procedure enables placement of a large interbody graft into the disc space for anterior column support while avoiding obstacles associated with. The extreme lateral interbody fusion xlif corpectomy technique is a minimally disruptive surgical procedure performed through the side of the body.
The patient is positioned on the surgical table on his or her side. The current main techniques of posterior lumbar interbody fusion plif surgery all incorporate a supplementary intervertebral implant. The expedium spine system incorporates technique simplifying designs, including a state of the art internal closure mechanism and a comprehensive set of implants designed in harmony with the instruments, which maximise performance and meet the challenge of even the most difficult pathologies. Surgical technique lateral accesssurgical considerations xlif the xlif technique described in this guide utilizes a lateral, retroperitoneal, transpsoas approach to access the intervertebral disc.
It allows exposure of the lateral aspect of the lumbar disc through a lateral approach with the possibility to insert a wide footprint interbody cage as a standalone procedure or associated with a uni or bilateral percutaneous fixation. Xlif was created in 2003 and has proven to be a safe and effective technique for spinal fusion that allows for very little discomfort compared to earlier surgical techniques. Timberline lateral fusion systemsurgical technique guide. An alif approach requires the organs in the abdomen and some of the major blood vessels to be moved to the side so that the surgeon can reach the. Surgical technique preparing the patient place the patient in a direct lateral decubitus position on the operating room table to ensure suitable visualization of the trajectory of the retraction through the soft tissue. Spine extreme lateral interbody fusion xlif neurodiagnostics. Primalok sp is a bilateral locking plate system which attaches. Mar 10, 2016 pdf on mar 10, 2016, ioannis siasios md and others published extreme lateral interbody fusion xlif. The nerves of the lumbar plexus reside within the psoas, and the technique. Nov 18, 2010 xlif extreme lateral interbody fusion is a minimally invasive surgical procedure where the spine is approached from the side of the body to replace damaged disc material with an implant between. Lumbar fusion with the xlif technique preoperative information.
In recent years, the extreme lateral interbody fusion xlif technique, which uses a transpsoas retroperitoneal approach, has been popularized as a minimally disruptive alternative surgical option for anterior column reconstruction and. The extreme lateral interbody fusion xlif technique, which uses a transpsoas retroperitoneal approach, has been popularized as a minimally invasive alternative surgical option for anterior. An introduction to xlif extreme lateral interbody fusion this booklet is designed to inform you about the extreme lateral interbody fusion xlif surgical procedure. The following general surgical technique guide is for illustrative purposes only. Place an auxiliary roll, bean bag or other device underneath the patients greater trochanter. Surgical technique the patient is placed on a flexible surgical table in a true lateral decubitus 90 position so that the patients greater trochanter or iliac crest is directly over the table break. Lumbar fusion with the xlif technique preoperative. Using patented nerve monitoring technology, the surgeon gains lateral side access to. Xlif the industry changing procedure continues to transform patients lives, transform surgical practices, and transform hospitals ability to provide superior, bestincare patient results. Surgical tech classes find the right school for surgical. A surgical approaches to the lumbar spine for interbody fusion techniques. It is designed to treat a range of spinal pathologies.
If percutaneous rod placement is desired, make a skin incision 2. Extreme lateral interbody fusion xlif is a relatively new technique whereby access to the disc space is achieved through a minimally invasive lateral, retroperitoneal, transpsoas approach. For an xlif surgery, we have the patient undergo anesthesia while lying on their back. The expedium spine system incorporates techniquesimplifying designs, including a state of the art internal closure mechanism and a comprehensive set of implants designed in harmony with the instruments, which maximise performance and meet the challenge of even the most difficult pathologies. Expandable tlif and plif technology surgical technique. These patient ambassadors share their firsthand experiences with the xlif procedure and help answer questions about what to expect after surgery. Heshe has an understanding of the procedure being performed and anticipates the needs of the surgeon. This is in direct contradistinction to a typical transpsoas approach in which the upper hip is usually flexed to relax the psoas muscle. Early complications of extreme lateral interbody fusion in. If desired, tilt the pelvis away from the spine to better expose operative disc space. Surgical outcome and related complications in an academic center.
Surgical approach single incision after making the skin incision and dividing the subcutaneous tissue, the oblique muscles of the abdomen will be visible. Lumbar transforaminal lumbar interbody fusion tlif. Xlif surgical technique extreme lateral interbody fusion or xlif19,23,24 is a 90degree o. Nuvasive launches retractor for lateral, supine approaches. The nerves of the lumbar plexus reside within the psoas, and the technique is dependent upon realtime electromyographic monitoring. Description the primalif liff interbody fusion system is a peek interbody cage system implanted to replace collapsed, damaged, or unstable vertebral discs due to degenerative conditions, tumor or trauma.
An alif approach requires the organs in the abdomen and some of the major blood vessels to be moved to the side so that the surgeon can reach the spine. The xlif procedure differs from an anterior interbody fusion alif because the surgeon performs the interbody fusion through an incision in the side of the body as opposed to the front of the body. Pdf on mar 10, 2016, ioannis siasios md and others published extreme lateral interbody fusion xlif. Xlif extreme lateral interbody fusion is a minimally invasive surgical procedure where the spine is approached from the side of the body to replace damaged disc material with an implant between. Lateral lumbar interbody fusion xlif is a minimallyinvasive procedure used to treat leg or back pain generally caused by degenerative disc disease. Xlif surgical technique study guide flashcards quizlet. Benefits xlif surgery traditional lumbar interbody fusion surgery.
The objective of this study was to describe our initial experience with an adaptation of the extreme lateral interbody fusion xlif technique allowing access to the anterior aspect of the thoracic and thoracolumbar spine with specific reference to 1 early pulmonary complications, 2 nonpulmonary complications, and 3 ability of this technique to successfully achieve spinal. You can also talk with a patient whos had the xlif procedure. Nuvasive has received regulatory shonin approval for several products to offer the xlif surgical technique as a minimally invasive option for lumbar spine fusion to patients and surgeons in japan. Over 400 published clinical studies support the procedure, documenting positive clinical. The llif or extreme lateral interbody fusion xlif technique was described by ozgur et al. Physicians use current procedural terminology cpt codes to report all of their services. Xlif procedure minimally disruptive procedure for spine. The procedure, called xlif extreme lateral interbody fusion, involves a lateral, or side, approach to spine surgery, rather than from the back or front. What to expect after an xlif procedure the better way back. Mark the skin at the anterior and posterior margins of the vertebral body, through the center and posterior third of the disc space. Plif, alif, tlif and xlif san diego spine foundation. Alif the xlif procedure differs from an anterior interbody fusion alif because the surgeon performs the interbody fusion through an incision in the side of the body as opposed to the front of the body. Direct lateral interbody fusion transpsoas approach dlif surgical technique instrument set 2 preoperative planning 7 nimeclipse spinal system needle electrode placement 8 patient positioning 10 localization 12 dissection to the psoas neuromonitoring through the psoas 14 dilation 16 retractor placement 16 disc preparation 19 trialing 23. For intramedullary fixation of proximal femoral fractures.
Compared with xlif surgery, the technique of olif surgery has not been described in detail yet. Olif25 procedure oblique lateral interbody fusion for l2 to l5 surgical technique as described by. This approach can be performed using two 3 to 4cm incisions. The approval furthers the companys ability to participate in the japanese market, adding the xlif approach to the cervical and posterior products.
Jan 22, 2015 adam kanter, md, director of the minimally invasive spine program at upmc presbyterian, narrates a stepbystep video and animation of the xlif extreme lateral interbody fusion spine procedure. It is not meant to replace any personal conversations that you might wish to have with your physician or other member of your healthcare team. In an xlif procedure, the spine is approached from the side of the body. Nvm5 was designed to enable a safer trajectory surgical technique. The extreme lateral interbody fusion xlif technique is a minimally disruptive surgical. Technique 2 a lowprofile version of the allinone for inserting and compressing separate instruments are used for provisional locking and final locking select this technique when using 4mm and 6mm implants t3 technique 3 this is the most decoupled version of each instrument and surgical step. For an xlif surgery, we have the patient undergo anesthesia while lying. Nuvasive investor relations investor overview nuvasive inc. Oblique lateral interbody fusion olif is a surgical technique that the company says minimizes cutting to muscles and addresses unmet needs seen with traditional lateral approaches by utilizing an obliquelateral trajectory to access multiple levels of the lumbar spine.