XLIF: Lateral Lumbar Spine Surgery
Surgical interventions present a wide range of indications and needs to correct acute or chronic problems. With regard to spinal surgical treatment, thanks to advances in biomedical sciences, engineering, as well as improvements in protocols and the quality of imaging tests, it is possible to make full predictions before an intervention regarding the material required, the approximate surgical time, and improve the choice of a less aggressive approach, treating the pathology completely, allowing us to achieve an effectiveness that was difficult to imagine a few decades ago.
Article index
1. What is lateral approach lumbar spine surgery?
2. Indications for lateral lumbar spine surgery
3. How is lumbar surgery performed via a lateral approach?
4. Recommendations before and after lumbar surgery via lateral approach
5. Follow-up to lumbar surgery via lateral approach
6. Advantages of lateral limbal spine surgery
What is lateral approach lumbar spine surgery?
It is a selective intervention performed on one side to treat severe disc disease that affects the biomechanics of the lumbar spine.
Indications for lateral approach lumbar spine surgery
This procedure is primarily indicated for moderate to severe lumbar disc disease. It is also a treatment for scoliosis, spondylolysis, spondylolisthesis, disc protrusions, and herniated discs. While disc disease can persist for a long time and continue to cause constant symptoms with recurrent attacks, chronic lesions with osteoarthritis or posterior joint deformity can produce both central and foraminal stenosis, causing very specific symptoms depending on the level of compression. These symptoms are justified by failure of conservative treatment or ongoing and evolving neurological involvement. The anterior approach is often specifically indicated for disc disease, with a careful assessment of whether it will be possible to avoid vascular injury during the procedure. This technique is usually applied regularly to patients who have previously undergone surgery. An experienced surgeon understands these concepts very well and, before proposing this treatment, will have provided an accurate diagnosis and explained the therapeutic alternatives in your case.
How is lateral lumbar surgery performed?
It is performed in the operating room under general anesthesia, for which a preoperative examination with the anesthesiologist is necessary, which may be done a few days beforehand. During the procedure, a fluoroscope is also used to locate the area to be treated, marking it before the incision and using it to monitor the procedure to avoid making mistakes and treating unaffected segments. The procedure usually lasts between 30 and 40 minutes on average and consists of removing the disc causing the problem with the placement of a prosthesis that will allow proper movement of the segment once it consolidates in the vertebral body, or a fixed disc that will prevent the segment from moving incorrectly and damaging the nerves exiting the spine, as well as preventing the progression and development of osteoarthritis in the posterior joints.
Recommendations before and after lumbar surgery via lateral approach
Before undergoing this procedure, a thorough medical evaluation and appropriate lumbar support with posterior reinforcement are recommended. The procedure has different protocols that will be specified according to the patient's health status, but a one-night hospital stay and discharge the following day are recommended. Patients are advised to rest for three weeks, as well as prophylactic medical treatment with anticoagulants, anti-inflammatory drugs to treat inflammation caused by the surgery, and surgical wound care, which can be easily performed at home if a family member is present. Before authorizing home discharge, an X-ray will be performed to assess the material placed in the spine and an assessment with early indications for physical therapy and spinal care prior to the surgery. If you are a smoker, it is recommended to quit smoking or limit activity to a minimum, as this delays the consolidation of the material and can prolong the postoperative period by several weeks.
Follow-up to lumbar surgery via lateral approach
After 15 days after the intervention, the surgical team will assess the patient's progress, and the patient's postoperative period can begin to gradually integrate with mobility and movement measures to promote muscle strengthening. Radiographic follow-up with 2 assessments scheduled at one and three months after the intervention will also be performed. However, if necessary, the patient's condition will be assessed at all times, especially if circumstances outside the protocol may arise, such as falls at home, surgical wound infections, or pain that is difficult to manage due to medication intolerance or side effects. Recommendations for returning to daily life without effort may be indicated from the third week onwards, including the start of physical therapy prior to gradually returning to daily life. Driving is permitted from the first month after surgery, unless specifically indicated by the surgeon.
Advantages of lateral lumbar surgery
Some of the advantages of this type of intervention are: Less bleeding. Lateral spinal surgery is performed in 30-40 minutes. Hospital discharge in 1 day.
Recuerda que esta información está hecha con fines de divulgación y que sólo un especialista en columna vertebral, indicará cual es el tratamiento oportuno para tu problema de columna vertebral.
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