First, a small incision (usually 1-2 inches) is made on the side over the area of the affected spinal disc or vertebrae where a series of dilating tubes will be inserted. The muscle structures near the incision site are gently retracted, as opposed to being cut or dissected, and surgical tools and implants are slipped between the muscles. Next, under fluoroscopic guidance (real time X-ray visualization) the impinged spinal nerve is placed to the side and a substantial amount of the intervertebral disc and/or any bone materials are removed. Using the lateral incision made earlier a structural implant that also contains bone graft is placed into the disc space to restore normal height and stability to the spine.

This bone graft implant creates a biological response and, over time, this bone graft will knit together with the adjoining vertebrae and form one continuous and stable vertebra.

Next, a small metal rods and screws are implanted between the two vertebrae to ensure stability. The incision is then closed with small stitches.

In many cases, an XLIF can be performed on an outpatient basis due to the reduced trauma to the spine and muscular structures. In fact, most patients are up and walking shortly after this procedure and physical therapy will begin within a few days of the procedure.