Traditionally, lumbar spine surgery was performed utilizing long incisions on the lower back, and involved extensive dissection of the muscles that attach to the spine.
These approaches also meant longer operative times, more blood loss during surgery, and a much longer recovery.
The development of advanced minimally-invasive techniques has allowed us to accomplish the same goals with much smaller incisions, minimal dissection of the muscles that attach to the spine, shorter operative times, and less blood loss.
Minimally-invasive Lumbar Fusion Techniques
eXtreme Lateral Interbody Fusion
One such technique is the XLIF (eXtreme Lateral Interbody Fusion), where a small incision is made on the side of the abdomen, and a specialized retractor and nerve monitoring equipment is used to safely access the spinal disc.
Anterior Lumbar Interbody Fusion
Another such technique is the ALIF (Anterior Lumbar Interbody Fusion), where an incision is made on the front of the abdomen and the abdominal muscles are retracted to the side to access the front of the spine. In both techniques, once the approach is made, the disc is removed, and a cage and bone graft material is placed in the disc space, decompressing the nerves and stabilizing the spine.
Advantages toMinimally-invasive Lumbar Fusion
These minimally-invasive approaches are advantageous in that, unlike the posterior approaches, both the back muscles and nerves remain undisturbed.
Another advantage is that placing the bone graft in the front of the spine places it in compression, and bone in compression tends to fuse better.
Lastly, a much larger implant can be inserted through an anterior approach, and this provides for better initial stability of the fusion construct.