[Extreme lateral interbody fusion. Indication, surgical technique, outcomes and specific complications].

Background: Extreme lateral interbody fusion (XLIF) is an interbody fusion technique, in which access to the lateral part of the disc is achieved via a strong lateral transpsoatic approach. In general, the technique can be applied between T5 and L5. For lumbar segments, neuromonitoring is mandatory to protect the iliolumbar plexus during the psoas passage.
Objectives: In this article, the results regarding use of the XLIF technique are summarized and compared with other anterior and anterolateral approaches. In addition, current publications regarding indication, technique, complications and clinical/radiological outcome measures are discussed.
Methods: The results of a literature review are presented and discussed.
Results: Regarding the indication and the surgical options for segmental restoration, the XLIF technique is comparable to anterior or anterolateral and open lateral interbody fusion. The minimally invasive XLIF access promises potentially lower morbidity than open procedures and the risk of injury of the iliac vessels is lower than in anterior and anterolateral approaches.
Conclusion: Increasing numbers of spine surgeons are using the XLIF method. Current results indicate that XLIF is a safe and reproducible technique for deformities, adjacent level disease, and instability.