Orthopedic & Neurologic Surgery of the Spine
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XLIF (Direct Lateral Fusion)

XLIF or Extreme Lateral Interbody Fusion is one of a growing number of surgeries that take a minimally invasive approach. With this technique, the surgery is performed by entering the body from the side (laterally) to help relieve the underlying cause for symptoms, such as long-term back or leg pain that has proven resistant to other forms of treatment. Prior to Dr. Peelle performing an XLIF, they will typically attempt to use more conservative approaches to treat your symptoms. These approaches may include physical therapy, steroid injections, and pain medication aimed at alleviating them.

What makes XLIF stand apart from other procedures is the point of entry for the surgery. As mentioned above XLIF surgeries take place through the patient’s side, taking a lateral approach to the spine, avoiding the major bones, ligaments, and muscles of the back. Some of the benefits of this approach include a reduced surgery time and hospital stay, a quicker return to normal activity, reduced pain, and lower incidents of blood loss and scarring. All of these are reasons that Dr. Peelle may choose to perform an XLIF.

If you think your spinal condition might be eligible for treatment with XLIF, consult Dr. Peelle about your symptoms. If this surgery is right for you Dr. Peelle may set you on the path to getting this treatment. XLIF can be the perfect approach for those patients whose conditions are compatible with its minimally invasive approach.


1. What can I expect after my procedure?

While every patient’s recovery is a little different, they’ll share some commonalities. Most patients are released from the hospital within a day or two under their physicians advisement. Following your surgery you may be fitted with a brace, and will have to take care with sitting, standing, and walking within 24 hours of the surgery. Your recovery to your previous lifestyle will take some time, and a return to your activities will be gradual and should be discussed at each follow-up with Dr. Peelle.

2. What risks are there in XLIF?

All surgeries, however minor, come with a certain degree of risk. While this procedure is a safe and proven technique, the complications that are most commonly associated with it are ongoing pain, infections, anesthesia related issues, problems with the hardware or graft taking, and nerve damage. If you have concerns about your surgery, before or after, discuss them with Dr. Peelle immediately.

3. What conditions are treated with XLIF?

Many spinal conditions can be treated with XLIF, with the most common being degenerative disc disease that presents with instability, the right or left curvature of the spine known as scoliosis, degenerative spondylolisthesis, and recurrent disc herniation, just to name a few. In some cases your case may be too severe for XLIF, including grade 2 or higher spondylolisthesis, cases where direct nerve decompression is required, and cases where retroperitoneal scarring is present. This last occurs due to an abscess on the spine, or from prior surgeries.

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