X360 is a comprehensive lateral approach to single-position surgery that leverages advanced techniques and technologies to deliver patient-specific care while enhancing OR workflow and efficiency.

The leader in lateral position spine surgery

The X360 system, powered by Surgical Intelligence™, includes XLIF®, XALIF™, and XFixation™. The integration of these procedures into a single system allows for significant time savings through the use of modern, less invasive techniques performed with the patient in the lateral position throughout the entire surgery.

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Advanced Materials Science (AMS) interbody technology with X360

Adhering to the three core principles of AMS, surface, structure, and imaging, NuVasive has pioneered design and manufacturing methods that combine the inherent benefits of porosity with the advantageous material properties of PEEK and Ti.

Modulus porous titanium interbody offerings

Modulus ALIF
Modulus ALIF is the latest Modulus addition to our AMS portfolio. The optimized porous Ti lattice structure paired with a variety of low-profile implant inserter options, enables this implant to be utilized for both XALIF and Supine ALIF approaches.

Modulus XLIF
Modulus XLIF is the NuVasive porous TI implant designed for use in the XLIF procedure. It's surface, structure, and imaging characteristics make it a desirable interbody option.

Porous PEEK interbody offerings

Cohere XLIF
Cohere is the first and only lateral Porous PEEK interbody available on the market, desiged to promote bone in-growth1 while maintaining the inherent biomechanical1 and imaging properties of PEEK.



Reduce OR time by up to 60 minutes2 and save nearly $5,000 per patient in hospital costs3,4

Enhance OR workflow and efficiency

Reduce time under anesthesia and lower intraoperative risks5,6


XALIF surgery


XALIF has all the characteristics of a traditional supine ALIF and is specifically designed to access L5-S1, but is performed with the patient in the lateral decubitus position. The versatile retractor system enables access for multiple ALIF approaches and bridges the gap between traditional supine ALIF and the XLIF procedure.

XLIF Lateral Surgery


In 2003, NuVasive revolutionized spine surgery with XLIF, the only lateral approach spine procedure supported by extensive clinical evidence in more than 400 peer-reviewed, XLIF-specific publications. With hundreds of thousands XLIF surgeries since its inception, the procedure continues to transform patients’ lives through reduced blood loss, less time in the OR, and shortened hospital stays as compared to traditional posterior fusion procedures.8 -15

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XFixation is an adapted posterior fixation technique with the patient kept in the lateral position. This allows single-position surgery to be achieved from the upper thoracic spine to the sacrum when combined with XLIF and/or XALIF procedural solutions.

NuVasive Innovation Event - March 17, 2022

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Surgeon education

Clinical education redesigned.

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Development team to sign up for a course.

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One platorm


Integrated technologies to enable
better spine surgery.

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1. Drazin D, Kim TT, Johnson JP. Simultaneous lateral interbody fusion and posterior percutaneous instrumentation: early experience and technical considerations. Biomed Res Int 2015:Article ID 458284.
2. Macario A. What does one minute of operating room time cost? J Clin Anesth 2010;22(4):233-6.
3. Shippert RD. A study of time-dependent operating room fees and how to save $100,000 by using time-saving products. Am J Cosmet Surg2005;22(1):25-34.
4. Olsen MA, Mayfield J, Lauryssen C, et al. Risk factors for surgical site infection in spinal surgery. J Neurosurg 2003;98(2):149-55.24.
5. Olsen MA, Nepple JJ, Riew KD, et al. Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am 2008;90(1):62-9.
6. Lehmen JA, Gerber EJ. MIS lateral spine surgery: A systematic literature review of complications, outcomes, and economics. Eur Spine J 2015;24(3):287-313.
7. Torstrick FB, Safranski DL, Burkus JK, et al. Getting PEEK to stick to bone: the development of porous PEEK for interbody fusion devices. Tech Orthop 2017;32:158-166.
8. Oliveira L, Marchi L, Coutinho E, et al. The use of rh-BMP2 in standalone eXtreme Lateral Interbody Fusion (XLIF®): clinical and radiological results after 24 months follow-up. World Spinal Column J 2010;1(1):19-25.
9. Dakwar E, Cardona RF, Smith DA, et al. Early outcomes and safety of the minimally invasive, lateral retroperitoneal transpsoas approach for adult degenerative scoliosis. Neurosurg Focus 2010;28(3):E8.
10. Goldstein CL, Phillips FM, Rampersaud YR. Comparative effectiveness and economic evaluations of open versus minimally invasive posterior or transforaminal lumbar interbody fusion. Spine 2016;41(8S)S74-89.2.
11. Sembrano, JN, Tohmeh A, Isaacs R, et al. Two-year Comparative Outcomes of MIS Lateral and MIS Transforaminal Interbody Fusion in the Treatment of Degenerative Spondylolisthesis. Spine 2016;41(8S):123-32.
12. Isaacs RE, Sembrano JN, Tomeh AG, et al. Two-Year Comparative Outcomes of MIS Lateral and MIS Transforaminal Interbody Fusion in the Treatment of Degenerative Spondylolisthesis. Spine 2016; 41(8S):133- 44
13. Dhall SS, Wang MY, Mummaneni PV. Clinical and radiographic comparison of mini–open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up. J Neurosurg Spine 2008;9:560-5.
14. Whitecloud TS 3rd, Roesch WW, Ricciardi JE. Transforaminal interbody fusion versus anteriorposterior interbody fusion of the lumbar spine: a financial analysis. J Spinal Disord 2001 Apr;14(2):100–3.
15. Lucio JC, VanConia RB, DeLuzio KJ, et al. Economics of less invasive spinal surgery: an analysis of hospital cost differences between open and minimally invasive instrumented spinal fusion procedures during the perioperative period. Risk Manag Healthc Policy 2012;5(5):65-74.