Lateral lumbar interbody fusion — performed through the patient's side rather than the back or front — allows Dr. Chavarria to place a large interbody cage between the vertebrae through a very small incision, with minimal blood loss and no disruption to the back muscles. XLIF and LLIF are powerful tools for treating multi-level disc disease, flatback deformity, and degenerative scoliosis.
What Is XLIF / LLIF?
Lateral lumbar interbody fusion accesses the disc space through a small incision on the patient's side (flank), passing between the ribs and pelvis through the retroperitoneal space. Unlike posterior approaches that require the patient's back muscles to be moved aside, lateral approaches reach the disc entirely through the natural body cavity space — avoiding the paraspinal muscles entirely.
A large, wide interbody cage is placed from the side, spanning a greater portion of the vertebral endplate than posterior cages. This provides powerful disc height restoration, indirect nerve decompression by stretching the foramen open, and a large surface area for bone fusion. Pedicle screws can then be placed percutaneously (through small skin punctures) from the back to complete the construct.
XLIF (eXtreme Lateral Interbody Fusion) and LLIF (Lateral Lumbar Interbody Fusion) refer to the same conceptual approach with variations in the specific retractor systems and access portals used. Both techniques are applicable to the mid-lumbar spine (typically L2–L4). The L4–L5 and L5–S1 levels require different approaches due to the position of the iliac crest and iliac vessels.
Are You a Candidate?
- Patients with multi-level degenerative disc disease causing back and leg pain
- Patients with adult degenerative scoliosis or flatback deformity needing multi-level correction
- Patients with disc collapse and foraminal stenosis that can be indirectly decompressed by restoring disc height
- Patients who prefer to avoid the back muscle disruption of traditional posterior fusion
- Patients in whom an anterior approach (ALIF) is not feasible due to vascular anatomy or prior abdominal surgery
What to Expect
Pre-operative: Imaging review including MRI and standing X-rays to assess spinal balance and plan the correction. Neuromonitoring is used intraoperatively to protect the nerves passing through the retroperitoneal space.
Day of surgery: XLIF/LLIF is often combined with posterior percutaneous screw placement in the same surgical session. One to two levels can be completed in 2–3 hours; multi-level deformity correction takes longer and typically requires a one to two-night stay.
First 4 weeks: Patients experience mild flank soreness and occasionally thigh numbness or tingling (from retraction near the lumbar plexus) that typically resolves within 4–12 weeks. Activity restrictions include no heavy lifting or bending. Walking is encouraged.
3–6 months: Physical therapy begins at 4–6 weeks. Serial X-rays confirm fusion progress. Most patients with degenerative disc disease return to full activity at 3–6 months; complex deformity corrections may have a longer rehabilitation timeline.
Why Choose Dr. Chavarria for Your XLIF / LLIF in Reno?
- No disruption of the back muscles — minimal posterior approach morbidity
- Large interbody cage allows powerful disc height and alignment restoration
- Indirect decompression — often eliminates need for a separate decompression procedure
- Can treat multiple levels through a single small lateral incision
- Significantly less blood loss than traditional open posterior fusion
- Excellent option for degenerative scoliosis and multi-level disc disease