Degenerative disc disease Surgery -
Direct Lateral Interbody Fusion (DLIF)

Long term scientific study has showed that in certain patient suffering from chronic back pain or sciatica, lumbar spinal fusion can provide long term cure of the symptoms. The cause of chronic back pain or sciatica including Degenerative Disc Disease or trauma to the back. The goal of a spinal fusion is to restore spinal stability. The procedure typically involves removing the disc material between two adjacent vertebrae and then placing an implant and bone graft material into the disc space. The implant and graft material encourage bone to grow in the space permanently joining the two vertebrae together (fusion). Rods and screws are then placed along the back of the spine to create an “internal cast” that supports the spine during the healing process.

What is Direct Lateral Interbody Fusion (DLIF)?

The DLIF procedure is a lateral (from the side) approach to spinal fusion that allows access to the area of the spine to be treated. It could minimize disruption of the surrounding soft tissues, muscles, nerves, and blood vessels.

DLIF is different from traditional interbody fusion techniques because the neurosurgeon makes a small incision in the patient’s side to approach the spine instead of making a larger incision on the patient’s front or back. Unlike the anterior spinal fusion, there is no need to retractor the major blood vessel or bowel. Unlike the posterior spinal fusion, there is no need to retract and damage the muscle and solid bone at the back.

To access the disc to be treated, the DILF procedure creates a narrow passageway through the underlying tissues and muscle by gently separating the fibers of the muscles rather than cutting through them. During the intervertebral disc disease surgery, a device may be used to identify the location of spinal nerves and protect them.

Intervertebral disc disease surgery – Procedures

For a minimally invasive DLIF procedure, you will be sedated under general anesthesia and the neurosurgeon will then:

  • Use image guidance to ensure you and your spine are in the proper position;
  • Make a small incision in your side and bluntly separate the abdominal muscles;
  • Use the image guidance system as a guide to insert a probe through the soft tissues and muscle fibers. This is followed by a series of dilators (Figure 1) to widen the space and finally a retractor (2-3 cm in diameter) to provide a lighted channel through which the surgeon may access your spine to:

  • Remove all or part of the affected disc and surrounding tissues (discectomy)
  • Prepare the bone surfaces of the adjacent vertebrae for fusion (Figure 2)
  • Place an implant and bone graft material from your own body into the disc space to promote fusion (Figure 3), along with additional instrumentation

Once pressure is relieved and the spine is stabilized, the surgeon will remove the retractor and close the incision (Figure 4).

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There are many surgical treatment options available for degenerative spine conditions, and your doctor will work with you to determine your option. Minimally invasive techniques aim to accomplish the same clinical goals as traditional “open” surgeries but cause less retraction of your muscles and other tissue.

What are the risks of the surgery?

Transient thigh region numbness may occur but nearly all such symptom recovered within a few weeks. Potential risks may occur occasionally, include failure of the vertebral and graft to fuse properly, implant migration, wound infection and bleeding in the wound. Most of these complications can be treated with rest and medications without long term consequences. In unusual cases, surgical treatment of the conditions may be needed. The following potential risks may rarely occur include neurological damage, damage to the surrounding soft tissue, having to transition to a conventional open procedure, etc… These risks are lower than that of the corresponding traditional surgery.

The information on this website is for general educational purpose only.
Readers should consult their neurosurgeon before considering treatment, and should not interpret their condition solely based on the information above.