|The Neurosurgery Spine Center is Northwest Arkansas exclusive provider of the Nuvasive® XLIF procedure - one of the most innovative spine surgery technologies available today.
XLIF - or eXtreme Lateral Interbody Fusion - is an innovative approach to spine fusion, accessing the spine from the side of the body instead of the front or back like traditional methods. The spine can be approached from the mid-thoracic spine to the L4-5 disc space in the lower back. This side entry means sensitive back muscles are not disturbed and no bone removal is required. This means less postoperative pain and early return to normal function. By avoiding a direct frontal approach, there is less risk of injury to structures in the abdomen such as the large blood vessels, bowel, and the kidney draining tubes.
And because there is little muscle dissection, less bone work and smaller incisions, there is less blood loss, less operative time, and less pain to the patient as compared to standard open spine surgery.
|A small incision is made toward your back|
|Since the XLIF uses small incisions and the MAXCESS system to access the spine, Dr. Blankenship generally performs the procedure with only an overnight stay. Depending on your general health and other factors, a same day discharge to home is also possible.
(For more information on MAXCESS, click here).
The procedure is done under general anesthesia. After you are asleep, you will be placed on your side and an X-ray will be taken of your spine to show Dr. Blankenship the location of the operative disc space. Your skin will be marked to show the site for the side incision. Before any surgical incision is made, Dr. Blankenship will perform a spinal injection to bathe the nerves in the spine in narcotics to allow pre-emptive analgesia to occur.
Dr. Blankenship will then make a small incision on your side, and using his finger will guide tubular dilators into position moving between, not through, the abdomen and the spinal muscles. As he advances the tubes through the psoas muscle on the side of your vertebrae X-ray and NeuroVision® nerve monitoring help guide him to the correct position on your spine and away from nearby nerves.
Once the dilators are in place, Dr. Blankenship will insert the MAXCESS retractor over them to provide lighted visibility and instrument access to the disc space. With the disc now visible and all nerves in the muscle safely retracted, Dr. Blankenship will remove the disc and prepare the disc space for fusion. He'll then place a large stabilizing implant into the empty disc space to restore the proper height and support the loads put on that spinal segment. A titanium plate will frequently be placed over the implant to stabilize the construct. When the implant and plate is in position, the retractor is removed and final confirmation X-rays are taken. Dr. Blankenship will close the small skin incisions with a few stitches that are under the skin. No dressing is required.
|(As viewed within the body from above)
X-rays and NeuroVision® nerve monitoring help guide Dr. Blankenship to the destination spot on the spine.
|Once the tubular dilators are in place, a tissue retractor is inserted and held open to provide lighted visibility and instrument access to the disc space.|
|Generally speaking, since the XLIF procedure requires less physical trauma than standard techniques, most patients will have a speedier recovery and be able to resume normal activities in a shorter period of time.|
|With the disc now visible and accessible, Dr. Blankenship removes the disc and prepares the disc space for fusion.
He then places the stabilizing implant into the disc space and removes the retractor, leaving only a few small stiches and a bandage for the small skin incision.
To see a video of this process, please click here.