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

The leader in lateral 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 lateral throughout the entire surgery.

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Reduce OR time by up to 60 minutes1 and save nearly $5,000 per patient in hospital costs2,3

Enhance OR workflow and efficiency

Reduce time under anesthesia and lower intraoperative risks4,5


XALIF surgery


XALIF has all the characteristics of a traditional supine ALIF and is specifically designed to access L5-S1, but 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 O.R., and shortened hospital stays as compared to traditional posterior fusion procedures.6

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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.

Surgical intelligence
The surgical intelligence ecosystem of technologies is an integral part of the X360 workflow. Pulse® brings surgical intelligence to life in the operating room by integrating all of the required technologies for spine surgery into a single platform.
01-Surgical Planning-white

Surgical planning

02-Alignment Assessment-white

Alignment Assessment




Rod Bending

-Smart Imaging-white

Smart Imaging



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.