3 Different Approaches Used to Perform a Minimally Invasive Lumbar Fusion

A Minimally Invasive Lumbar Fusion is a surgical procedure used to treat lower back and/or leg pain that is associated with movement. The procedure is among the most commonly performed procedures in spine surgery. It is used to treat the following conditions:
  • Degenerative disc disease
  • Disc herniation
  • Sciatica
  • Spinal instability
  • Osteoarthritis
  • Lumbar spinal stenosis
In recent years, findings in medical research and advancements in surgical techniques have allowed the procedure to be performed minimally invasively using one of the following three approaches:
  1. An anterior approach. From the front.
  2. A posterior approach. From the back.
  3. A lateral approach. From the side.
Before learning more about each approach, it is important to go over the basics of a lumbar fusion procedure.

An Overview of a Lumbar Fusion

During a lumbar fusion procedure, a Neurosurgeon partially or completely removes lumbar intervertebral disc or discs that are damaged or diseased. If the spinal cord or a spinal nerve is compressed or pinched, a decompression is performed by removing pieces of vertebral bone that are putting pressure on the nerve. An implant, referred to as a cage, packed with bone graft is placed in the disc space and the vertebrae are fixated using rods and screws. Following the procedure, bone graft and existing bone fuse to form a single, solid vertebra that no longer produces pain with movement.

The Three Approaches

  1. A posterior lumbar interbody fusion (PLIF) is the most commonly performed lumbar fusion procedure. Painful lumbar vertebrae are accessed by making a small incision over the lower back and gently retracting lumbar muscles and nerves. The advantages of the posterior approach are that it allows the surgeon to fuse multiple levels of vertebrae and easily perform a spinal decompression if it is needed.
  2. An anterior lumbar interbody fusion (ALIF) uses an anterior approach. The lumbar vertebrae are accessed by making a small incision near the abdomen and retracting the abdominal muscles and contents to the side. Accessing the lumbar vertebrae in this fashion is advantageous because the lumbar muscles and nerves are not traumatized. This speeds up the recovery process and enables patients to respond well to physical therapy.
  3. A direct lateral or extreme lateral interbody fusion (DLIF or XLIF) accesses the lumbar vertebrae using a lateral approach. During a DLIF or XLIF, the patient is placed on their side and a small incision over their flank is made. The benefits of the approach are similar to those of an ALIF.

Seeking Treatment

Lower back and/or leg pain should not limit your life. If you're experiencing these symptoms, please contact one of our 3 Southern California offices to make an appointment. Receiving a proper diagnosis and treatment plan will help get you on the road to recovery.

Dr. Anthony Virella is a Board-Certified, Fellowship trained Neurological Spine Surgeon with advanced training in the management of complex spinal disorders. He attended medical school at Columbia University College of Physicians and Surgeons and is a graduate of the UCLA Neurosurgery Residency Program. Dr. Virella is a nationally recognized specialist in the field of complex and Minimally Invasive Spine Surgery and has offices located in Agoura Hills, Valencia and Palmdale. If you, or someone you love, is suffering from persistent neck or back pain, contact us today to schedule an appointment.

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