There are a few specific instances where the XLIF procedure could not be performed.
Instances in which a patient could not have an XLIF procedure would include:
- A fusion in the disc space between the 5th lumbar and 1st sacral vertebrae (L5-S1) because it is below the level of the pelvic brim, which inhibits access to the disc space from the side.
- For some patients with a low riding L4-L5 level, access from the side through an XLIF may also not be an option
- Some deformities with significant rotation
- High grade spondylolisthesis
- Bilateral retroperitoneal scarring (from a prior abscess or abdominal surgery)
As with any spinal fusion, each patient should be assessed individually and a discussion of suitability should take place between the patient and surgeon.