What are the disadvantages of XLIF?

Answered by James Kissner

The disadvantages of XLIF (lateral lumbar interbody fusion) procedure include several potential complications and risks. These can vary depending on individual circumstances and the experience of the surgeon performing the procedure.

1. Approach-related groin and anterior thigh pain: The XLIF procedure involves accessing the spine through a lateral (side) approach. This can sometimes lead to postoperative pain in the groin and anterior thigh region. This discomfort can be temporary or persistent, and its severity can vary from person to person.

2. Numbness and paresthesia in the thigh: The nerves in the thigh can be affected during the XLIF procedure, leading to numbness or abnormal sensations (paresthesia) in the thigh. This can be temporary or, in rare cases, permanent.

3. Hip flexor weakness: The hip flexor muscles, responsible for lifting the leg at the hip joint, can be weakened or affected during the XLIF procedure. This can result in difficulty with certain movements or activities that involve hip flexion. Physical therapy may be required to regain strength and function.

4. Risk of nerve root injury from lumbar plexus: The lumbar plexus, a network of nerves in the lower back, is in close proximity to the surgical site during XLIF. There is a potential risk of nerve root injury during the procedure, which can lead to sensory changes, weakness, or pain in the lower extremities.

5. Incomplete decompression of neural elements: While XLIF is primarily a fusion procedure, it may involve decompression of neural elements if indicated. However, the lateral approach may not always provide complete access to all areas of the spine, potentially limiting the extent of neural decompression that can be achieved.

6. Implant-related complications: As with any spinal fusion procedure, there is a risk of complications related to the implants used, such as cage migration, fracture, or loosening. These complications may require revision surgery to address.

7. Inadequate fusion or pseudarthrosis: Fusion failure or pseudarthrosis, where the bones do not fully fuse together as intended, can occur after XLIF. This can result in ongoing pain or instability and may require further intervention, such as revision surgery.

It is important to note that these potential disadvantages and complications are not experienced by every patient undergoing XLIF. The overall success and outcome of the procedure also depend on various factors, including the patient’s overall health, the surgeon’s expertise, and adherence to postoperative care instructions.

Please consult with a qualified spine surgeon to discuss the specific risks and benefits of XLIF based on your individual circumstances.