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Lateral Lumbar Interbody Fusion: Revolutionizing Spine Surgery

Aug 30, 2019

Venu Vemuri, D.O.

A new and exciting technique to treat spinal conditions is now available at LOC.  Lateral lumbar interbody fusion(LLIF) is a minimally invasive spine surgery to “open up” the spinal canal when the nerves are being squeezed causing pain.  An added benefit, LLIF offers simultaneous rigid support of the spine until fusion occurs naturally over time.  Traditional spine surgery has focused on directly removing bone, ligaments, discs, etc. to free up tight painful nerves.  The bony removal often destabilizes the spine requiring a fusion. Potential complications with this technique include scarring around the nerves (arachnoiditis), dural tear, and large blood loss.  With LLIF, these risks are eliminated.

By approaching the spine from the side of the body, special retractors and instruments can be used to remove the disk and place bone in a sturdy implant that serves to literally lift-up the spine freeing the nerves indirectly.  To understand this affect think of an inversion table.  By hanging inverted, gravity pulls the spinal column into alignment indirectly lining up the spinal nerves relieving pain.  Unfortunately, we cannot hang upside down forever!  With LLIF you CAN get that feeling permanently.  The result is no need to directly access the nerves lessening the chance for painful scarring around the nerve or dangerous tearing of the dura.

The power of the large implants can also straighten crooked spines.  Scoliosis can afflict adults as the discs degenerate and the spine twists and curves.  This painful condition does not always respond well to usual treatments like physical therapy or shots.  With LLIF the curved spine can be straightened by leveling out the crooked disc spaces.  I will often do this in a staged fashion with part 1 being the LLIF, and part 2 the “back” side where screws and rods are placed in a minimally invasive way to complete the surgery.  Blood loss, pain, infection rate, and recovery are all dramatically reduced with this new approach.

If you think you could benefit from this new approach in spine surgery, please schedule an appointment to find out if you are a candidate.


Fig 1. LLIF cage shown placed where the disc was removed.


Fig. 2 Before and after MRI images showing the ability of LLIF to “open up” the previously tight spinal canal.


Fig. 3 Before x-ray showing scoliosis and collapsed discs (red arrows) at nearly all levels causing a “flat back”.  Notice the red circles in the right image showing the compressed tunnels where the lumbar nerves exit.


Fig. 4 After staged surgery using LLIF to straighten out the crooked spine and restore the natural “swayback” of the lumbar spine.


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Louisville Orthopaedic Clinic

4130 Dutchman's Lane,
Suite 300,Louisville 40207
(502) 897-1794

Northgate Medical Center

3605 Northgate Court,
Suite 207,New Albany 47150
(812) 920-0408

Louisville Orthopaedic Clinic
4130 Dutchman's Lane
Suite 300
Louisville, KY 40207
Northgate Medical Center
3605 Northgate Court
Suite 207
New Albany, IN 47150