By approaching spine surgery from a different angle, surgeons help patients recover faster.
The disks that give the spine its flexibility are remarkable structures, but they’re not immune to change. Over time, they can weaken and break. These changes may lead to conditions that cause pain or make the spine curve abnormally, such as spondylolisthesis or degenerative scoliosis.
Physical therapy, medication and steroid injections help many patients find relief from disk-related back and leg pain, but others run the gamut of conservative treatments without success. For them, spinal fusion surgery to remove the deteriorated disk and shore up the spinal column is an option — and now, a minimally invasive one.
Splitting the Difference
Saint Joseph East, part of KentuckyOne Health, now offers eXtreme Lateral Interbody Fusion (XLIF®), a procedure that uses a 2-inch incision in patients’ left side rather than a larger one in the back.
“Entering through the side allows us to split muscles instead of cutting them, as is usually done in a traditional fusion performed from the back, so patients experience less pain,” said James Rice, MD, a fellowship-trained spine surgeon at Kentucky Orthopedic Associates and Saint Joseph East. “Once we get to the spine, we remove the damaged disk and replace it with an implant containing bone substitute. The implant will support the spine while bone grows over the area to join the vertebrae. We may use screws or plates to hold the implant in place while fusion occurs.”
Patients typically spend at least one night in the hospital after XLIF, a shorter stay than with traditional spinal fusion. XLIF leaves patients with a smaller scar and allows them to regain mobility and recover faster. Patients can walk and drive short distances soon after surgery but should avoid heavy lifting and repetitive motion short term, according to Dr. Rice.
“When it comes to lower back fusions, individuals who opt to have XLIF are some of my happiest patients,” Dr. Rice said. “They have outstanding results compared with patients who have traditional fusions.”
Part of what makes eXtreme Lateral Interbody Fusion a safe, precise procedure is NVM5®, an electronic intraoperative monitoring system. NVM5 is like a high-tech road map for the surgeon. The system updates the surgeon in real time about the location and function of nerves — important information that helps reduce injury.
This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.
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