Lateral lumbar interbody fusion (LLIF)

Last revised by Arlene Campos on 12 Jan 2024

Citation, DOI, disclosures and article data

Citation:

Gaillard F, Campos A, Knipe H, et al. Lateral lumbar interbody fusion (LLIF). Reference article, Radiopaedia.org (Accessed on 20 Apr 2024) https://doi.org/10.53347/rID-59808

DOI:

https://doi.org/10.53347/rID-59808

Permalink:

https://radiopaedia.org/articles/59808

rID:

59808

Article created:

26 Apr 2018, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was created Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Last revised:

12 Jan 2024, Arlene Campos ◉

Disclosures:

At the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.

View Arlene Campos's current disclosures

Revisions:

11 times, by 5 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Spine

Synonyms:

Extreme lateral interbody fusion (XLIF)
eXtreme lateral interbody fusion (XLIF)
Direct lateral interbody fusion (DLIF)
AnteroLateral transPsoatic Approach (ALPA)

Lateral lumbar interbody fusion (LLIF), also commonly known by the proprietary names eXtreme Lateral Interbody Fusion (XLIF) or Direct Lateral Interbody Fusion (DLIF) ³, is one of many approaches to lumbar interbody fusion and is performed from T12/L1 to L4/5.

Unlike an ALIF, an LLIF is performed from a lateral transpsoas approach and does not require retroperitoneal or intraperitoneal dissection. The disc space is reached and a discectomy is performed. Into the defect is introduced a disc spacer cage and bone and/or graft material that will, in time, result in complete bony fusion ^1,2.

The newer XLIF and DLIF techniques allow a minimally-invasive approach. Neuromonitoring can be used in the XLIF technique ⁴.

Anterolateral screwed plates, posterior transpedicular instrumented fusion and posterior decompression can also be performed if indicated ^6,7.

Complications

lumbar plexus injury: ~15% (range 0.7-30%), 90% transient symptoms
bowel injury
vascular injury ⁴

Outcomes

fusion rates of ~97% are reported ⁴

History and etymology

This technique was developed in the early 2000s to be a safer alternative to the older anterior lumbar interbody fusion (ALIF), which was developed in the 1950s ^1,2.