Interbody Fusion - ALIF, PLIF and XLIF

Traditionally, there are a few ways to fuse the spine. One of these ways is known as interbody fusion. Interbody fusion is fusion of two vertebrae between the vertebral bodies (main trunk of the vertebra) in the anterior column (front part of the spine).

See Outpatient Lumbar Fusion

In order to fuse two vertebrae together using interbody fusion, the intervertebral disc in the front of the spine must first be removed. In the space created by the removal of the disc, an implant, such as a spacer or cage, will be inserted to help maintain the normal alignment of the spine. Additionally, a bone graft (real pieces of bone used to stimulate bone growth) or bone graft substitute (natural or synthetic material used to replace bone tissue and stimulate bone growth) will be placed in the space made between neighboring vertebrae to help them fuse together.



The XLIF procedure differs from an anterior interbody fusion (ALIF) because the surgeon performs the interbody fusion through an incision in the side of the body as opposed to the front of the body. An ALIF approach requires the organs in the abdomen and some of the major blood vessels to be moved to the side so that the surgeon can reach the spine. In order to minimize the risk of this part of the ALIF procedure, a vascular surgeon or general surgeon usually performs this part of surgery. In an XLIF procedure, the approach from the side does not require any major organs or blood vessels to be moved.


The XLIF procedure differs from a posterior interbody fusion (PLIF) because approaching the spine from the back requires major muscle groups to be cut. With the XLIF design and approach from the side, only the lateral muscles are separated along their fibers and there is no cutting or tearing of the muscle.