April 4, 2014

A new surgical procedure now available at CAMC can relieve back and leg pain without the trauma and recovery time of traditional spine surgery.

Extreme Lateral Interbody Fusion, or XLIF, is a minimally-invasive surgery that benefits patients who cannot tolerate a larger open back surgery or who have continued to experience back and leg pain following other failed treatments, such as steroid injections, physical therapy and/or pain medication.

CAMC is the only hospital in Charleston offering the procedure.

Unlike traditional spine surgery approaches, XLIF does not require entry through sensitive back muscles, bones or ligaments. Instead, neurosurgeons approach the spine from the patient's side through a small incision a few inches above the waistline. Special retractors are used to help protect the nerves. A neurosurgeon then removes the intervertebral disk, which is replaced with an intervertebral implant.

"Going from the side allows us to access the spine without having to strip the muscles off the spine, which has several advantages compared to going posterior [from the back]," said Matthew Walker, MD, Neurological Associates. "Most notably, patients have less surgical time, a shorter stay in the hospital, shorter recovery time, less scarring and blood loss ,and basically a shorter time to get back to normal activities."

Hospitalization time after surgery is normally about two days. Patients are up and walking the day of surgery, and physical therapy starts about two weeks after surgery. Patients are advised to avoid strenuous activities for four to six weeks.

"The biggest advantage of an XLIF procedure is in the approach," said John Orphanos, MD, Neurological Associates. "You can approach the spine from many different ways, but coming at it from the side you can actually go through a smaller incision, so there is less muscle destruction. The muscles that you go through are a very small layer.

Since they don't provide a lot of the stability from the spine that you get when you go from someone's back, there's a lot less pain involved post operatively."

An estimated 10 million adults suffer from chronic back and leg pain annually, a condition that can severely limit their activities. XLIF can be used to successfully treat many types of spinal conditions, including degenerative disc disease in the lumbar spine, recurrent lumbar disc herniation, low-grade spondylolisthesis, degenerative scoliosis and adjacent segment disease.

For more information about XLIF or other surgical options to treat back and leg pain, talk with your primary care physician.

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