Lumbar spine surgery by lateral approach

Xlif: Lateral Lumbar Spine Surgery

Surgical interventions present a wide range of indications and needs to correct the acute or chronic problem. With regard to surgical treatment of the spine, thanks to advances in biomedical sciences, engineering, as well as improvements in protocols and quality in imaging tests, it is possible to make all the predictions on the material that is It will require the approximate surgery time as well as improving the choice of a less aggressive approach, treating the pathology completely, allowing us to reach an effectiveness that a few decades ago was hardly imaginable.

Article index

1. What is lateral lumbar spine surgery?

2. Indications for lateral lumbar spine surgery

3. How is lateral lumbar surgery performed?

4. Recommendations before and after lateral lumbar surgery

5. Follow-up to lateral lumbar surgery

6. Advantages of lateral limbar spine surgery

What is lateral lumbar spine surgery?

It is a selective intervention that is performed on one side to treat a severe discopathy and that conditions the affectation of the biomechanics of the lumbar spine.

Indications for lateral lumbar spine surgery

This intervention is indicated mostly in moderate or severe disc disease at the lumbar level. It is also a treatment applied to scoliosis, spondylolysis, spondylolisthesis, protrusions and herniated discs. Although discopathies can last a long time and continue to give constant symptoms with recurrent crises, chronic lesions with osteoarthritis or posterior joint deformation can produce both central stenosis and foraminal stenosis, giving very specific symptoms depending on the level of compression and which is justified by a failure in conservative treatment or constant and evolving neurological involvement. A particular indication for the anterior approach usually occurs in discopathies, assessing assertively whether it will be possible to avoid vascular lesions during the procedure. This technique is usually applied on a regular basis, to patients who have previously undergone surgery. An experienced surgeon understands these concepts very well and before proposing this treatment, he will have made a precise diagnosis and explained the therapeutic alternatives in his case.

How is lateral lumbar surgery performed?

It is performed in the operating room under general anesthesia, for which a preoperative study with the anesthetist is necessary and can be performed a few days before. During the procedure, a fluoroscope is also used to locate the region to be intervened, marking before the incision and controlling the procedure with it to avoid commenting on errors and treating segments that are not affected. The procedure usually takes between 30 and 40 minutes. on average and consists of the removal of the disc that produces problems with placement of a prosthesis that will allow adequate movement of the segment once it is consolidated in the vertebral body or of a fixed disc that will prevent the segment from moving incorrectly and damaging the nerves that leave the spine as well as preventing the progress and development of osteoarthritis at the level of the posterior joints.

Recommendations before and after lateral lumbar surgery

Before performing this procedure, a correct medical evaluation and having a lumbar girdle with appropriate posterior reinforcement is recommended. The procedure has different protocols that will be specified according to the patient's health status, but a 1 night stay in the hospital is recommended and discharge the next day with recommendations for rest for 3 weeks as well as prophylactic medical treatment with anticoagulants, anti-inflammatories to treat the inflammation caused by the surgery, and cures of the surgical wound that can be done easily at home if we have the assistance of a family member. Before authorizing home discharge, a radiographic control will be carried out to assess the material placed on the spine and an evaluation with early indications of physiotherapy and care of the spine before the surgery performed. If you are a smoker, it is recommended to stop smoking or limit activity to the minimum possible because it delays the consolidation of the material, and may prolong the postoperative period for several more weeks.

Follow-up to lateral lumbar surgery

After 15 days after the intervention, the surgical team will assess your evolution and your postoperative period can begin to integrate little by little with mobility and displacement measures favoring muscle strengthening. A radiographic control with 2 assessments planned per month and 3 months after the intervention will also be carried out, although if necessary, the patient's situation will be assessed at all times, especially if circumstances outside the protocol could appear as falls at home, surgical wound infections or pain that is difficult to manage due to intolerance to medication or side effects to medications. The recommendation to resume daily life without effort may be indicated from the 3rd week, including the start of physiotherapy prior to gradually reincorporating to daily life. Driving a vehicle is allowed 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 between 30-40 minutes Discharge from hospital in 1 day

Remember that this information is made for disclosure purposes and that only a spine specialist will indicate the appropriate treatment for your spinal problem.

Spine pathologies

Other spinal treatments