What Is XLIF?

• In simple terms: XLIF fuses two vertebrae together by removing a damaged disc and placing a spacer (cage) filled with bone graft through a side incision.
  
  

• Scientifically: The lateral transpsoas approach provides direct access to the intervertebral disc space without disrupting posterior spinal muscles. A cage packed with autograft/allograft is inserted to restore disc height and promote arthrodesis (fusion).
  
  

Conditions Treated with XLIF

• Degenerative Disc Disease with collapse or instability
  
  

• Spondylolisthesis (low to moderate grade)
  
  

• Spinal Stenosis with instability
  
  

• Recurrent disc herniation requiring stabilization
  
  

• Post-traumatic degeneration or deformity correction
  
  

Benefits of XLIF

• Smaller incision compared to open back fusion
  
  

• Less muscle disruption (posterior muscles are spared)
  
  

• Shorter hospital stay (often 1–2 days)
  
  

• Faster recovery and return to activity
  
  

• Excellent restoration of disc height and indirect decompression of nerves
  
  

• Lower blood loss than traditional posterior approaches
  
  

The XLIF Procedure: Step by Step

1. Anesthesia & positioning – General anesthesia; patient positioned on their side.
   
   

2. Small flank incision – A 1–2 inch incision is made in the patient’s side.
   
   

3. Navigating through muscles – Tubular retractors gently spread the psoas muscle to access the disc space.
   
   

4. Disc removal – The damaged disc is removed.
   
   

5. Implant placement – A cage (spacer) filled with bone graft is inserted to restore disc height and promote fusion.
   
   

6. Stabilization – Screws, rods, or plates may be added through minimally invasive posterior incisions if needed.
   
   

7. Closure & recovery – Incision is closed; patients often walk the same day.
   
   

Risks and Limitations

• Nerve irritation in the psoas muscle (temporary thigh numbness/weakness possible)
  
  

• General surgical risks: infection, bleeding, hardware issues, non-union
  
  

• Not ideal for all levels of the spine (best for lumbar levels L1–L5)
  
  

• Rare complications include vascular or bowel injury
  
  

Recovery Timeline

• Day 0–1: Walking the same day or next morning
  
  

• Weeks 2–6: Light activities; many patients return to desk work
  
  

• Weeks 6–12: Fusion begins consolidating; activity increases with PT guidance
  
  

• 3–6 months: Progressive return to normal life; fusion solidifying
  
  

• 6–12 months: Complete bony fusion expected in most patients
  
  

Why Choose Desert Spine and Pain?

• Expert neurosurgeon – Dr. Greenwald is skilled in advanced MIS fusion approaches, including XLIF
  
  

• Patient-focused care – Thorough evaluation to determine if XLIF is the right option
  
  

• Smaller incisions, faster recovery – Minimally invasive techniques designed to reduce fear and downtime
  
  

• Comprehensive treatment – We combine MIS with PT, injections, and conservative care whenever possible
  
  

Frequently Asked Questions

How is XLIF different from traditional fusion?

XLIF uses a side approach instead of the back, sparing muscles and often allowing faster recovery.

Will I need rods and screws with XLIF?

Often yes. Posterior fixation adds stability and increases fusion success.

Is XLIF painful?

All surgery involves some discomfort, but XLIF typically causes less pain than open fusion.

How soon can I return to work?

Desk workers may return within 2–4 weeks; physical jobs may take 2–3 months.

How does Desert Spine and Pain perform XLIF differently?

We combine neurosurgical precision, navigation technology, and minimally invasive techniques under Dr. Greenwald’s expertise.