Extreme Lateral Interbody Fusion (XLIF)

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What is a Minimally Invasive Extreme Interbody Fusion (XLIF)?

An eXtreme Lumbar Interbody Fusion (XLIF) is a minimally invasive procedure that is used to treat a variety of spinal disorders including: spinal instability, spondylolisthesis (a slipped vertebra), degenerative disc disease, and spinal deformity—among many others.

The spine, composed of 33 vertebrae, is designed with cushions to help absorb a considerable amount of the pressure and weight imposed upon it as we move about our daily lives. These cushions, called intervertebral discs, sit between each set of vertebrae to provide shock absorption, lubrication, and mobility for the spine. When these discs become damaged, or start to degenerate over time, many difficulties can emerge—the chief complaints being pain, inflammation, and/or reduced mobility.


An eXtreme Lateral Interbody Fusion (XLIF) is a state-of-the-art, minimally invasive surgical procedure to relieve the pain and inflammation that is caused by disc degeneration. Whereas traditional spinal fusions involved invasive procedures with lengthy hospital stays and prolonged recovery times, a minimally invasive XLIF can offer a divergent alternative. XLIF may be a useful procedure for individuals dealing with debilitating pain in the thoracic (rib cage) or lumbar (lower back) regions of the spine. Most individuals with a diagnosis of degenerative disc disease, low level spondylolisthesis, or mild to moderate scoliosis may benefit from this minimally invasive option.

The procedure begins with a small incision in the side of the body near the waist. The surgeon will use tubing to form a tunnel and to access the vertebrae from the side. This tube allows your surgeon to bypass tender tissues, such as organs or muscles, and to carefully work without further damaging the spinal nerves. Next, all or part of the damaged disc will be removed, followed by the surgeon preparing this now empty disc space and inserting a spacer bone graft to reinstate the necessary gap between the vertebrae. A plate or rods and screws may be inserted to provide stability while the bone graft heals into place during the recovery process.

Here at NYC Spine, our world-renowned spine surgeon, Dr. Frazier, has been honing his surgical skills for the last 20 years. With 20 years of training, lab work, and real-life experience, Dr. Frazier has provided relief to innumerable patients using minimally invasive procedures, such as these. Call NYC Spine today to set up your first appointment with Dr. Frazier!

Can an Extreme Lumbar Interbody Fusion (XLIF) help me?

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What are the Benefits of a Minimally Invasive Extreme Lumbar Interbody Fusion (XLIF)?

A minimally invasive, eXtreme Lateral Interbody Fusion (XLIF) has many benefits, especially when compared to traditional open- back surgical procedures. Traditional spinal fusions involved large incisions, the disruption of internal organs and tissues, and a long recovery time; XLIF has precisely the opposite impact. The benefits include:

  • Less damage to surrounding structures: During this minimally invasive procedure, there is minimal damage to surrounding organs, muscles, and other tissues because of surgical entrance from the side of the body.
  • Less time in the hospital: Most patients will require a hospital stay of only 1-3 days, compared to the traditional interbody fusion that required 3-6 days in the hospital. Some people may even be able to have same day surgery depending on their situation and their advice of your doctor.
  • Less recovery time: Because there is less disruption to surrounding organs, muscles, and tissues, the recovery time is cut down dramatically. For example, whereas it once took 3 days for a person to be up walking after traditional open back surgery, many people who have undergone an XLIF are walking the same day of the procedure.

There is no doubting the fact that minimally invasive procedures are the way to go when dealing with such an important structure such as the spine. With a XLIF, the procedure is designed specifically to cause little to no damage to surrounding organs, muscles, ligaments, and tendons, while purposefully targeting the location of pain and spinal instability. This type of precision requires years of experience and training, and Dr. Frazier has just this. With a standard of individualized treatment, you will become a part of your own treatment team. And, under the guidance of Dr. Frazier, you can make decisions on the treatments that will be right for you and your specific situation.

How do I know if I need an Extreme Lumbar Interbody Fusion (XLIF)?

Request a free MRI review & our world-renowned orthopedic spine surgeon, Dr. Frazier, will evaluate your treatment needs.

Do I Qualify for a Minimally Invasive Extreme Lateral Interbody Fusion (XLIF)?

Those who are candidates for a Minimally Invasive eXtreme Lateral Interbody Fusion (XLIF) will be experiencing some degree of degeneration of the intervertebral discs in the thoracic and/or lumbar spine. A diagnosis of degenerative disc disease, scoliosis, or spondylolisthesis may all qualify an individual for this procedure. Before surgery, it is always suggested that all other routes to relief have been exhausted. Make sure pain management, physical therapy, lifestyle changes, nerve block injections and other procedures have been first on your list. When these conservative techniques have proven to be unsuccessful, then XLIF surgery might be your best option.

There are some factors that may disqualify a person from the procedure, however. One such case would involve damage or degeneration of the disc between the last vertebrae in the lumbar spine (L5) and the first disc in the sacral spine (S1). Because this surgery involves accessing the vertebrae from the side of the body, the location of this specific joint is inaccessible due to its proximity to the hip bone. Individuals who have extreme cases of scoliosis or spondylolisthesis may also be barred from receiving this procedure due to severity of the damage or extreme curvature of their spine. Other situations which may prevent one from having XLIF surgery include: allergies to any of the surgical or implant materials or prior surgery near the kidneys.

If you have any questions, concerns, or if you are wondering if this may be the right surgery for you, don’t hesitate to call NYC Spine today. Our team of specialists, which includes our internationally acclaimed spine surgeon, Dr. Frazier, will collaborate with you to provide relief for your painful spine condition.

Am I a candidate for an Extreme Lumbar Interbody Fusion (XLIF)?

Determine your eligibility for conservative & minimally invasive treatments.

Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.

After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.

Education & Training

  • MD / Cum Laude

    Harvard Medical School

  • Chief Resident

    Mass. General Hospital

  • Lecturer

    Columbia University

  • Spinal Deformity Fellowship

    Doctor’s Hospital (Miami, FL)