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XLIF by Pablo Pazmino MD

XLIF is a minimally invasive approach towards removing degenerated discs in the lumbar spine and fusing them in a minimally invasive manner. If you or someone you know may benefit from a XLIF feel free to contact us 1-8SPINECAL-1, doctor@beverlyspine.com, doctor@santamonicaspine.com or via the internet www.santamonicaspine.com or www.beverlyspine.com

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XLIF by Pablo Pazmino MD

  1. 2. Orthopaedic Surgery American Academy of Orthopaedic Surgeons Clinical Faculty Olympia Medical Center Cedars Sinai Medical Center Century City Doctors Hospital <ul><li>Education </li></ul><ul><ul><li>The University of California, Los Angeles </li></ul></ul><ul><ul><li>The University of Michigan, Ann Arbor </li></ul></ul>
  2. 3. <ul><li>The procedure is called eXtreme Lateral Interbody Fusion because the approach is made from the lateral aspect of the patient, i.e. the side/flank </li></ul>
  3. 4. <ul><li>Using Xrays in surgery, Dr Pazmino marks out two tiny incisions on the patients left flank with a pen </li></ul>
  4. 5. <ul><li>Here you can see how Dr Pazmino and his team operate while the patient is on the side </li></ul><ul><li>The Xray machine is critical in keeping this a minimally invasive procedure. Here you can see the machine is labeled “Fluoro”. </li></ul>
  5. 6. <ul><li>Dr Pazmino then creates two tiny incisions on the patient’s left side </li></ul><ul><li>Dr Pazmino then places a probe through one incision and uses this to guide his instruments away from neuromuscular structures. </li></ul>
  6. 7. <ul><li>These two small incisions are all Dr Pazmino requires to access the disc spaces </li></ul>
  7. 8. <ul><li>Here we see the Probe guiding Dr Pazmino away from the neural structures </li></ul><ul><li>The beauty of this procedure is that it allows Dr Pazmino to completey detect and avoid the nerves which lie along the side of the spine. </li></ul>
  8. 9. <ul><li>Now using Xrays in the OR Dr Pazmino is able to guide the same probe into the damaged disc of the spine </li></ul>
  9. 10. <ul><li>Dr Pazmino next uses dilators over the probe and opens the space in a minimally invasive manner where he plans to perform the surgery </li></ul>
  10. 11. <ul><li>Here we can see how Dr Pazmino places dilators of increasing size over the probe. </li></ul>
  11. 12. <ul><li>Now Dr Pazmino has set the final Dilation necessary to perform the entire XLIF procedure </li></ul>
  12. 13. <ul><li>This is what it looks like on Xray once Dr Pazmino is at the correct level </li></ul><ul><li>You can see the probe is inside the disc space </li></ul>
  13. 14. <ul><li>Now that Dr Pazmino has obtained the exact opening he requires to perform the XLIF he is able to insert a Retractor in a minimally invasive manner . </li></ul><ul><li>The retractor is inserted over the dilation tubes and probes </li></ul>
  14. 15. <ul><li>You can see how the retractor gives Dr Pazmino direct access to the disc space from the lateral position </li></ul><ul><li>This retractor is helpful in avoiding nerves and trauma to muscles </li></ul>
  15. 16. <ul><li>At this point Dr Pazmino removes the degenerated disc is identified through the retractor. </li></ul>
  16. 17. <ul><li>At this point Dr Pazmino removes the degenerated disc is through the retractor, and prepares the area for the XLIF. </li></ul>
  17. 18. <ul><li>Next Dr Pazmino sizes the disc space for the desired implant in terms of height, angulation, and depth. </li></ul>
  18. 19. <ul><li>A bony spacer implant, plastic or metal cage is filled with BMP, or bone graft and slid into the disc space. </li></ul><ul><li>This will indirectly relieve pressure from pinched nerve roots </li></ul>
  19. 20. <ul><li>Dr Pazmino next closes the retractor, and removes all surgical instrumentation. </li></ul>
  20. 21. <ul><li>With the retractor closed Dr Pazmino can then safely remove it from the small incisions </li></ul><ul><li>Dr Pazmino now prepares for final plastic surgical closure </li></ul>
  21. 22. <ul><li>The bone inside the spacer then will grow through the spacer, around the spacer and connects the vertebral bodies above and below. </li></ul><ul><li>Once solid this bony union is called a fusion. </li></ul>
  22. 24. <ul><li>All our procedures are performed in a minimally invasive manner. </li></ul><ul><li>All patients receive a plastics closure and are followed closely afterwards </li></ul>
  23. 25. <ul><li>Thank you for your time. </li></ul><ul><li>If you know someone who could benefit from a consultation for XLIF please refer them to our online website or call toll free to schedule an appointment </li></ul><ul><li>1-8SPINECAL-1 </li></ul><ul><li>www.beverlyspine.com </li></ul><ul><li>www.santamoincaspine.com </li></ul>

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