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What is direct lateral interbody fusion?

New Way of Performing Spinal Fusion

A lateral interbody fusion is a new way of performing spinal fusion surgery in select patients.

What is traditional lumber spinal fusion?

Lumbar spinal fusion is sometimes recommended to correct problems in the anatomy of the back. It involves removing damaged disc and bone from between two vertebrae and inserting material (bone graft) that promotes bone growth. As the bone grows, the two vertebrae join together (fuse). Fusing the bones together can help make a particular area of the back more stable, reducing problems related to nerve irritation. Sometimes, plates or screws are also used to help stabilize the bones. Fusions can be done at one or more segments of the spine.

What is the difference between traditional and lateral fusion?

Traditionally, the surgeon performing this surgery reaches the back through an incision in the abdomen, the back, or both (depending on the individual patient's anatomy and needs). With a lateral interbody fusion, the surgeon approaches the back through a small incision in the side of the body, using special tools and techniques. There are a number of other names for the same technique, including DLIF® (Direct Lateral Interbody Fusion), XLIF® (eXtreme Lateral Interbody Fusion), and transpsoas interbody fusion.

What are the advantages to the lateral approach?

The lateral interbody fusion is a less invasive way to perform spinal fusion surgery. In most cases, patients who are candidates for this surgery are those who would have needed an incision in the abdomen in order for the surgeon to reach the area of concern. Approaching the spine through the abdomen means the surgeon must get around large blood vessels, nerves, muscles, and organs that are in the way. This can prolong recovery following surgery and, in rare cases, can cause complications such as nerve or blood vessel damage.

The lateral approach provides an alternate route to the spine that disturbs far fewer structures and tissues. This, in combination with small incisions, means much less discomfort for the patient and fewer risks of complications.

Some patients who have this surgery may also need an incision in the back; others can have their entire operation completed through the lateral incisions.

Who is a candidate for lateral interbody fusion?

Not everyone who needs spinal fusion surgery is a good candidate for the lateral approach. It depends on many factors, especially the patient's own anatomy and exactly where the surgeon needs to go to fix the problem. However, for certain patients, the lateral approach provides a more gentle way to perform either all or part of a spine operation.

LIF: A Patient's Experience

Thomas Nelson is a supervisor for a company that manufactures plastic liners for drums, a physically demanding position. When he learned that he had spondylolisthesis, he had to decide whether to undergo surgery or get injections. Read more, including the surgeon's perspective >>

Another source of information about this procedure is this fact sheet from Medtronic Sofamor Danek. Your surgeon can explain more about whether lateral interbody fusion may be right for you. Please be sure to ask any questions you may have about this or any other aspect of your care.

Contact Information

Spine Center
Beth Israel Deaconess Medical Center
Shapiro Clinical Center, Second Floor
330 Brookline Avenue
Boston, MA 02215
617-754-9000
spinecenter@bidmc.harvard.edu

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