Also known as extreme lateral (XLIF) or direct lateral interbody fusion (DLIF), LLIF is a procedure that accesses the spine from incisions created on the side of the body. It is performed to provide relief from symptoms due to conditions such as:

• Degenerative disc disease, the natural deterioration of the spinal discs over time
• Degenerative scoliosis, a curvature of the spine caused by the degeneration of the facet joints
• Herniated disc, damage to the spinal discs that causes nerve “pinching” or impingement
• Spinal tumors, abnormal tissue growth in or on the spine
• Spondylolisthesis, a condition in which one of the vertebrae of the spine slips out of place

The focus of a surgical treatment is to drastically improve quality of life. Back doctor Dr. LaRocca may propose back surgery in the event of noticeable tiredness, extreme pains or when all other treatment options have been implemented.

What to Expect Before and After the Procedure

During the Procedure

During the procedure, Dr. LaRocca may approach the spine through an incision in the flank, the space on the side of the body between the ribs and the hip. In doing so, he avoids separating back muscles, cutting bone, moving major blood vessels, or moving spinal nerves as opposed to approaches such as:

• Anterior lumbar interbody fusion (ALIF)
• Posterior lumbar interbody fusion (PLIF)
• Transforaminal lumbar interbody fusion (TLIF)

A surgical instrument known as a tubular retractor is then inserted through the skin and onto the spinal column to hold the muscles open.

Once there is a clear view of the spine, the affected spinal disc material is removed and a spacer known as a cage containing bone graft material is placed in the empty space to encourage the two vertebrae to heal and fuse together. The bone graft material is rarely taken from the hip but may also be donated from a cadaver or consist of various biologically active materials that promote bone growth. Screws made of titanium may then be inserted to hold the cage in place.

There are a few advantages to this approach over other approaches, including:

• Avoiding the spinal nerves
• Better alignment of the vertebrae
• Easier access to the spine
• Faster recovery
• Less damage to the muscle tissue

Dr. LaRocca can help patients determine what approach is best based on the individualized needs of patients.

After the Procedure

Patients may be allowed to leave the day of surgery or the day after due to the minimally invasive nature of the procedure. Patients may return to normal activity within four to six weeks.