NuVasive®, Inc.
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The XLIF procedure is the first clinically-validated lateral approach to the spine. This
NuVasive® technique was created to be safe, reproducible, and minimally disruptive.
XLIF allows surgeons to accomplish fundamental surgical goals, such as anterior
column correction, fusion, and corpectomy, using conventional surgical techniques and a seamlessly integrated Maximum Access Surgery (MAS®) platform.

NuVasive XLIF<sup>®</sup> Watch the Video

Overview

Clinical Benefits

XLIF is the only lateral approach procedure validated by 10 years of clinical experience. More than 150 published clinical studies support the procedure, documenting excellent clinical outcomes such as reduced blood loss, less O.R. time, and shorter hospital stay, as compared to traditional fusions.

 

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The above data represents typical outcomes of patients being treated for degenerative disc disease, spondylolisthesis, and scoliosis.
View Sources

 

XLIF Surgery

 

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Lateral Approach

 

Traditional Lumbar Interbody Fusion Surgery

 

Posterior Approach

Posterior Approach

Anterior Approach

Anterior Approach

 

 

Nerve Monitoring

The XLIF procedure is supported by NVM5®, a clinically-validated nerve monitoring system that helps identify the location and integrity of nerves within the psoas muscle. This surgeon-directed system is designed to quickly determine relative nerve proximity to improve reproducibility of the approach.

Implants

NuVasive offers a portfolio of application-specific implants designed for a variety of patient anatomies and pathologies.

 

View Case Studies

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Support

Surgeons

For more information on these innovative solutions or to learn how you can integrate the XLIF procedure in your practice, contact your local NuVasive Sales Consultant or call Customer Service.

Customer Service
800-475-9131

Patients

To learn more about what to expect from XLIF surgery, please visit Patient Solutions.

XLIF information and support is also available from
The Better Way Back®.

Join the Community
www.thebetterwayback.org
info@thebetterwayback.org
800-745-7099

Conditions

 

degnerative-disc-diseaseDegenerative Disc Disease

Degenerative disc disease (DDD) is a loss of the functional integrity of the disc, which can lead to painful micromotion, disc collapse, and progressive degenerative pathologies, including disc prolapse or herniation, degenerative spondylolisthesis, degenerative scoliosis, degenerative lateral listhesis, and degenerative stenosis.

Value of XLIF

The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions such as DDD. In DDD, anterior column correction can be accomplished using the XLIF procedure, providing stability, indirect decompression, and sagittal and coronal alignment.

Case Study

For a 65-year-old female with degenerative disc disease and resulting mechanical low back pain and radiculopathy confirmed by positive discogram at L2-L3, surgical treatment was achieved through single-approach lateral exposure and fixation with XLIF DecadeTM plate. Operative time was 47 minutes, estimated blood loss was less than 50cc, and the patient was discharged after less than 24 hours in the hospital.

 

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Advanced DDD with Resultant Degenerative Spondylolisthesis

degenerative-spondylolisthesisVertebral body displacement associated with advanced degenerative disc disease with resultant spondylolisthesis can lead to central, sub-articular, and foraminal stenosis. Traditionally when treating degenerative spondylolisthesis, the surgical goals are to decompress the nerves, stabilize the spine, stop painful motion, and obtain a fusion across the unstable level. Some potential issues when treating degenerative spondylolisthesis from the traditional posterior approach include abnormal sagittal alignment following laminectomy with in situ posterior fusion, limited reduction ability, small interbody implant options that may lead to subsidence, and disruption of posterior musculature and facets.

Value of XLIF

The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. Ligamentotaxis is accomplished through a lateral approach with the placement of a large interbody implant, resulting in restoration of disc height, correction of alignment, and indirect decompression. XLIF has been shown to provide indirect decompression of central, sub-articular, and foraminal stenosis. View Source

Lordotic implants also enable restoration of sagittal alignment.

 

Case Study

For a 57-year-old female with advanced DDD with resultant Grade I degenerative spondylolisthesis and central and foraminal stenosis, XLIF was used to reduce the spondylolisthesis, restore sagittal alignment, and achieve indirect decompression.

 

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Advanced DDD with Resultant Degenerative Scoliosis

degenerative-scoliosisDegenerative scoliosis is primarily a result of advanced degeneration of the disc with asymmetric disc collapse, vertebral body wedging, and loss of facet joint competence. Traditionally, there have been many challenges in treating coronal and sagittal imbalances, the loss of lordosis, anterolisthesis, and rotary listhesis, as well as foraminal stenosis.

 

Value of XLIF

The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. Ligamentotaxis is accomplished with the placement of a large interbody implant, resulting in restoration of disc height, correction of alignment (sagittal, coronal, and axial planes), and indirect decompression. In particular, focal foraminal stenosis from coronal malalignment can be alleviated with an XLIF interbody implant.

Case Study

For a 65-year-old female with advanced DDD and resultant degenerative scoliosis and central and foraminal stenosis, XLIF at L3-L5 resulted in restoration of disc height, correction of sagittal, coronal, and axial alignment, and indirect decompression, while minimizing the morbidity associated with traditional approaches.

 

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Adjacent Segment Degenerative Disc Disease

adjacent-segment-diseaseAdjacent segment disease describes new symptoms caused by the disc degeneration of a mobile segment directly above or below a previous spinal fusion. Traditionally, it has been a challenge to navigate through scar tissue from the prior surgery to address the new symptomatic segment. Other potential issues when treating adjacent segment degenerative disc disease have included removal or extension of existing posterior instrumentation, direct decompression following a previous posterior surgery, restoration of sagittal balance, and common occurrences of nerve injuries, dural tears, and vascular injuries.

 

Value of XLIF

The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. The lateral approach provides access through virgin anatomy, avoiding scar tissue and helping to mitigate risk of nerve or vascular injuries. In addition, this technique eliminates the need to remove
existing hardware.

Case Study

An 81-year-old female who underwent L3-S1 fusion nine years prior was experiencing mechanical lower back pain. Degenerative disc disease adjacent to a prior fusion was confirmed by MRI. She demonstrated low-grade slip in flexion/extension. L2-L3 XLIF with XLIF DecadeTM plate fixation allowed access through virgin anatomy and resulted in restoration of disc height, correction of sagittal alignment, and indirect decompression, while minimizing the morbidity associated with traditional approaches. The patient was discharged from the hospital the same day as her surgery.

 

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Tumor/Trauma

Partial or complete resection of a vertebral body—a corpectomy procedure—is usually performed to treat a spinal fracture or tumor. Traditional thoracic corpectomy procedures require a thoracotomy—resection of a rib, deflation of the ipsilateral lung, and insertion of a chest tube upon close to remove air and fluid from the chest. These surgical requirements contribute to increased postoperative pain and pulmonary complications such as atelectasis and pneumonia.

 

Value of XLIF

The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. For corpectomy, XLIF offers conventional surgery through a less disruptive approach, minimized exposure-related patient morbidity, and seamlessly integrated instrument, implant, and fixation platforms.

Case Study

A 17-year-old male was involved in a snowboarding accident that resulted in an L1 fracture with complete motor deficit. The patient was treated with XLIF corpectomy of the L1 vertebral body and anterior plating fixation through the same lateral approach within two hours of injury. The patient regained motor function and at 12 months postoperatively returned to activity as a collegiate athlete.

 

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DDD with Sagittal Plane Deformity

Sagittal-Plane-DeformitySagittal plane deformity resulting from advanced degenerative disc disease is an increasingly recognized cause of pain and disability in adult patients. Several studies show that adequate restoration of sagittal plane alignment, in addition to spinopelvic balance, is essential for desirable outcomes in adult deformity. Traditional methods used to correct fixed sagittal deformities include posterior-based osteotomies, such as Smith-Petersen osteotomies (SPO) and three-column resections, such as pedicle subtraction osteotomies (PSO) and vertebral column resections (VCR). However, these techniques are associated with significant morbidity, including prolonged operative times, neurological complications, and a high volume of blood loss. View Source

Value of XLIF

The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. XLIF Anterior Column Realignment (ACR™) allows surgeons to access the anterior column of the thoracic and lumbar spine from the lateral position to divide the anterior longitudinal ligament (ALL) and provide anterior column fusion using hyperlordotic implants in adult patients with deformities secondary to advanced degenerative disc disease. This technique provides an alternative method to traditional open procedures and allows surgeons to address sagittal imbalance from the anterior column, while adhering to standard deformity principles.

Case Study

For a 77-year-old male patient with advanced degenerative disc disease with resultant scoliosis and sagittal imbalance, XLIF ACR resulted in restoration of sagittal balance, correction of alignment, indirect decompression, and restoration of disc height, while minimizing the extent of posterior osteotomies and associated morbidity.

 

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Support

Surgeons

For more information on these innovative solutions or to learn how you can integrate the XLIF procedure in your practice, contact your local NuVasive Sales Consultant or call Customer Service.

Customer Service
800-475-9131

Patients

To learn more about what to expect from XLIF surgery, please visit Patient Solutions.

XLIF information and support is also available from
The Better Way Back®.

Join the Community
www.thebetterwayback.org
info@thebetterwayback.org
800-745-7099

Single-Approach Surgery

Single-Approach Surgery with the XLIF Decade™ Plate

single-approach-surgerySingle-Approach Surgery describes the surgical treatment of a spinal segment through one surgical exposure. Using the NuVasive XLIF Decade plate, the surgical objective of stabilizing the operative spinal level can be achieved through a minimized lateral incision without the need for additional surgical incisions and/or posterior instrumentation.

Value of XLIF

The XLIF Decade plate is optimized for use with the XLIF approach, procedure, and instrumentation. By enabling surgical treatment through a single incision, patient morbidity, surgical time, blood loss, and recovery time can be minimized compared to traditional fusions. In appropriate patients, XLIF in combination with the XLIF Decade plate fulfills the surgical goals of instrumented interbody fusion, without compromise.

 

Case Study

For a 65-year-old female with degenerative disc disease and resulting mechanical low back pain and radiculopathy confirmed by positive discogram at L2-L3, surgical treatment was achieved through single-approach lateral exposure and fixation with the XLIF Decade plate. Operative time was 47 minutes, estimated blood loss was less than 50cc, and the patient was discharged after less than 24 hours in the hospital.

Pre-Op

Pre-Op 1

Pre-Op 2

Pre-Op 3

Post-Op

Post-Op 1

Post-Op 2

xlif-logo

 

Support

Surgeons

For more information on these innovative solutions or to learn how you can integrate the XLIF procedure in your practice, contact your local NuVasive Sales Consultant or call Customer Service.

Customer Service
800-475-9131

Patients

To learn more about what to expect from XLIF surgery, please visit Patient Solutions.

XLIF information and support is also available from
The Better Way Back®.

Join the Community
www.thebetterwayback.org
info@thebetterwayback.org
800-745-7099