Minimally invasive spinal fusion procedures such as a lateral lumbar interbody fusion (LLIF) are performed to relieve pain radiating from the lower back into the buttocks or legs. “Interbody fusion” refers to surgery in which an intervertebral disc is removed and the adjacent vertebrae are fused together.
The LLIF is different from other forms of spinal fusion surgery because it uses a lateral, or side, approach to the spinal column. By approaching from the side of the body, the spine can be reached with minimal tissue damage and minimal risk. In addition, the side approach to the spine provides access to the damaged disc without requiring removal of any vertebral bone. Since the LLIF process is minimally invasive to the muscles and tissues at the site, recovery is often faster than with other fusion procedures.
The LLIF can be used to treat nerve compression, disc degeneration, spondylolisthesis, and other painful lower back conditions. Typically, our surgeons will recommend a fusion rather than a laminectomy when there is instability or deformity of the bones of the spine.
The surgeon will make a small incision in the side through which he will insert an imaging device (called fluoroscopy) to help to ensure precision as the surgeon removes the damaged disc and other nearby debris. This restores room for the nerves that have been compressed. He will then insert a cage (or spacer) made of either titanium or plastic and packed with bone graft into the disc space. The surgeon will then secure either a metal plate or screws and rods to the vertebrae to maintain stability of the spine around the cage as the vertebrae grow together and fuse.
Once the LLIF procedure is complete, imaging is used again to confirm accurate placement. The surgeon then closes the incisions with sutures. Depending on the extent of spinal damage being addressed, the LLIF procedure typically takes between one and three hours.
After undergoing an LLIF procedure, patients typically remain in the hospital overnight. A physical therapy regimen is started soon after to assist the patient in regaining strength and mobility. Certain activities may be restricted, including lifting, twisting the midsection, and bending at the waist. Many patients can return to work within a few weeks after the procedure if their employment does not require strenuous exertion. However, heavy lifting and manual labor are prohibited for 3-6 months after the procedure, depending on the extent of the surgery.