Omurga Cerrahisi
/ XLIF


XLIF eXtreme Lateral Interbody Fusion
The XLIF procedure is the first clinically-validated lateral approach to the spine. This NuVasive® technique was created to be safe, reproducible, and minimally disruptive. XLIF allows surgeons to accomplish fundamental surgical goals, such as anterior column correction, fusion, and corpectomy, using conventional surgical techniques and a seamlessly integrated Maximum Access Surgery (MAS®) platform.





OVERVIEV

Clinical Benefits
XLIF is the only lateral approach procedure validated by 10 years of clinical experience. More than 140 published clinical studies support the procedure, documenting excellent clinical outcomes such as reduced blood loss, less O.R. time, and shorter hospital stay, as compared to traditional fusions.



The above data represents typical outcomes of patients being treated for degenerative disc disease, spondylolisthesis, and scoliosis. View Sources



Nerve Monitoring
The XLIF procedure is supported by NVM5®, a clinically-validated nerve monitoring system that helps identify the location and integrity of nerves within the psoas muscle. This surgeon-directed system is designed to quickly determine relative nerve proximity to improve reproducibility of the approach.

Implants
NuVasive offers a portfolio of application-specific implants designed for a variety of patient anatomies and pathologies.



CONDITIONS

Degenerative Disc Disease (DDD)

Degenerative Disc Disease
Degenerative disc disease (DDD) is a loss of the functional integrity of the disc, which can lead to painful micromotion, disc collapse, and progressive degenerative pathologies, including disc prolapse or herniation, degenerative spondylolisthesis, degenerative scoliosis, degenerative lateral listhesis, and degenerative stenosis. Value of XLIF

The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions such as DDD. In DDD, anterior column correction can be accomplished using the XLIF procedure, providing stability, indirect decompression, and sagittal and coronal alignment.




DDD With degenerative Scoliosis

Advanced DDD with Resultant Degenerative Spondylolisthesis
Vertebral body displacement associated with advanced degenerative disc disease with resultant spondylolisthesis can lead to central, sub-articular, and foraminal stenosis. Traditionally when treating degenerative spondylolisthesis, the surgical goals are to decompress the nerves, stabilize the spine, stop painful motion, and obtain a fusion across the unstable level. Some potential issues when treating degenerative spondylolisthesis from the traditional posterior approach include abnormal sagittal alignment following laminectomy with in situ posterior fusion, limited reduction ability, small interbody implant options that may lead to subsidence, and disruption of posterior musculature and facets.

Value of XLIF
The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. Ligamentotaxis is accomplished through a lateral approach with the placement of a large interbody implant, resulting in restoration of disc height, correction of alignment, and indirect decompression. XLIF has been shown to provide indirect decompression of central, sub-articular, and foraminal stenosis. View Source

Lordotic implants also enable restoration of sagittal alignment.

Adjacent Segment Disease

Advanced DDD with Resultant Degenerative Scoliosis
Degenerative scoliosis is primarily a result of advanced degeneration of the disc with asymmetric disc collapse, vertebral body wedging, and loss of facet joint competence. Traditionally, there have been many challenges in treating coronal and sagittal imbalances, the loss of lordosis, anterolisthesis, and rotary listhesis, as well as foraminal stenosis.

Value of XLIF
The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. Ligamentotaxis is accomplished with the placement of a large interbody implant, resulting in restoration of disc height, correction of alignment (sagittal, coronal, and axial planes), and indirect decompression. In particular, focal foraminal stenosis from coronal malalignment can be alleviated with an XLIF interbody implant.

Adnacent Segment Disease

Adjacent Segment Degenerative Disc Disease
Adjacent segment disease describes new symptoms caused by the disc degeneration of a mobile segment directly above or below a previous spinal fusion. Traditionally, it has been a challenge to navigate through scar tissue from the prior surgery to address the new symptomatic segment. Other potential issues when treating adjacent segment degenerative disc disease have included removal or extension of existing posterior instrumentation, direct decompression following a previous posterior surgery, restoration of sagittal balance, and common occurrences of nerve injuries, dural tears, and vascular injuries.

Value of XLIF
The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. The lateral approach provides access through virgin anatomy, avoiding scar tissue and helping to mitigate risk of nerve or vascular injuries. In addition, this technique eliminates the need to remove existing hardware.

Tumor/Trauma

Tumor/Trauma
Partial or complete resection of a vertebral body—a corpectomy procedure—is usually performed to treat a spinal fracture or tumor. Traditional thoracic corpectomy procedures require a thoracotomy—resection of a rib, deflation of the ipsilateral lung, and insertion of a chest tube upon close to remove air and fluid from the chest. These surgical requirements contribute to increased postoperative pain and pulmonary complications such as atelectasis and pneumonia.

Value of XLIF
The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. For corpectomy, XLIF offers conventional surgery through a less disruptive approach, minimized exposure-related patient morbidity, and seamlessly integrated instrument, implant, and fixation platforms.

DDD Withsagittal Plane Deformity

DDD with Sagittal Plane Deformity
Sagittal-Plane-DeformitySagittal plane deformity resulting from advanced degenerative disc disease is an increasingly recognized cause of pain and disability in adult patients. Several studies show that adequate restoration of sagittal plane alignment, in addition to spinopelvic balance, is essential for desirable outcomes in adult deformity. Traditional methods used to correct fixed sagittal deformities include posterior-based osteotomies, such as Smith-Petersen osteotomies (SPO) and three-column resections, such as pedicle subtraction osteotomies (PSO) and vertebral column resections (VCR). However, these techniques are associated with significant morbidity, including prolonged operative times, neurological complications, and a high volume of blood loss. View Source

Value of XLIF
The XLIF procedure was created to be a safe and reproducible, minimally disruptive surgical technique for spine conditions. XLIF Anterior Column Realignment (ACR™) allows surgeons to access the anterior column of the thoracic and lumbar spine from the lateral position to divide the anterior longitudinal ligament (ALL) and provide anterior column fusion using hyperlordotic implants in adult patients with deformities secondary to advanced degenerative disc disease. This technique provides an alternative method to traditional open procedures and allows surgeons to address sagittal imbalance from the anterior column, while adhering to standard deformity principles.


Case Study
For a 77-year-old male patient with advanced degenerative disc disease with resultant scoliosis and sagittal imbalance, XLIF ACR resulted in restoration of sagittal balance, correction of alignment, indirect decompression, and restoration of disc height, while minimizing the extent of posterior osteotomies and associated morbidity.



SINGLE-APPROACH SURGERY

Single-Approach Surgery with the XLIF Decade™ Plate
single-approach-surgerySingle-Approach Surgery describes the surgical treatment of a spinal segment through one surgical exposure. Using the NuVasive XLIF Decade plate, the surgical objective of stabilizing the operative spinal level can be achieved through a minimized lateral incision without the need for additional surgical incisions and/or posterior instrumentation.

Value of XLIF
The XLIF Decade plate is optimized for use with the XLIF approach, procedure, and instrumentation. By enabling surgical treatment through a single incision, patient morbidity, surgical time, blood loss, and recovery time can be minimized compared to traditional fusions. In appropriate patients, XLIF in combination with the XLIF Decade plate fulfills the surgical goals of instrumented interbody fusion, without compromise.




Omurga Cerrahisi



    1. Nuvasive
    2. XLIF






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