XLIF Potential Risks and Complications

The extreme Lateral Interbody Fusion (XLIF) procedure, like any other surgical procedure, has certain potential risks and complications associated with it.

Possible risks and complications associated with the XLIF include but are not limited to:

  • Persistent pain/continued pain after surgery
  • Failure to fuse (pseudoarthrosis, or non-union)
  • Infection
  • Muscle weakness
  • Vascular injury (injury of the blood vessels)
  • Neurologic injury (nerve or spinal cord damage)
  • Urinary tract infection
  • Stroke
  • Pneumonia
  • Deep vein thrombosis (clotting)
  • Persistent pain at the site of bone graft harvest (in the hip)
  • Further progression of existing spinal disease

One particular risk in the XLIF approach is to the lumbar plexus. This is especially true in trying to approach the lower lumbar segments (L4-L5). The retractor used for the XLIF places pressure on the nerves running through the iliopsoas, and although EMG monitoring can help minimize this risk, neural compromise from retraction on the muscle is still a possibility. The damage can range from thigh pain alone to weakness in the quadriceps. The risk is mainly dependent on the size of the patient, the location of the fusion and the experience of the surgeon.

As with any surgical procedure, a discussion detailing all potential risks of the XLIF procedure should take place between the physician and the patient.