XLIF + ILIF is proposed as a minimally invasive fixation option for single-level disc disease or grade 1 spondylolisthesis. A study of 11 patients found good clinical outcomes with reduced surgical time, blood loss, and hospitalization compared to other circumferential constructs. CT scans showed evidence of fusion in the intersomatic space in one patient but no fusion in interspinous or interlaminar spaces after three months. The technique provides stabilization without cage subsidence but longer term studies are needed.

1. XLIF + ILIF ®circumferential aarrtthhrrooddeessiiss aass aa mmiinniimmaallllyy
iinnvvaassiivvee ffiixxaattiioonn ooppttiioonn:: cclliinniiccaall rreessuullttss aanndd iimmaaggiinngg ssttuuddyy
Nicola Zullo M.D.
Functional Unit of Neurosurgery
Clinica Eporediese-Policlinico di Monza Ivrea
Spine Surgery Division
Humanitas Gavazzeni Bergamo
Chief: Corrado Musso M.D.

2.  01.01.2013-07.01.2014: 22 + 46
circumferential procedures
 XLIF+ILIF®: 11 cases out of 22
 Nine out of 11 patients meet the
criteria of the present study, 8
patients were evaluated at least
three months after surgery and were
enrolled
 VAS/ODI scores were collected pre
and post operatively
 Fusion rate was evaluated in 3 cases
with lumbar CT scan

3. XLIF + ILIF® INDICATIONS
 single level discopaty with or without central/foraminal
stenosis (main treatment option)
 Single level discopaty with Grade 1 spondilolystesis
EXCLUTION CRITERIA
 Spondilolystesis > grade 1
 Spinal deformity (scoliosis, sagittal imbalance)
 Multilevel discopaty

4. SURGICAL TECHNIQUE
 Standard XLIF® procedure
 Modified ILIF® (lateral or prone position)
 If necessary, microsurgical uni or bilateral
interlaminotomy /foraminotomy with spinous processes
and articular sparing
 ILIF ® modified technique:
 Usually interlaminar spacer Magnitude device not used
 Extensive removal of sopra and interspinous ligaments
 Careful decortication of spinous processes and laminar
boundaries
 Interspinous space filled with Bone allograft (Attrax® putty or
eterologous cancellous bone)

5. SURGICAL TECHNIQUE

6. FOLLOW UP

7. FOLLOW UP

8. POST-OP CT SCAN pz1

9. POST-OP CT SCAN pz2

10. POST-OP CT SCAN pz3

11. CONCLUSIONS
 XLIF® + ILIF® is a good, time sparing and minimally invasive fixation
option for single level discopaty/grade 1 spondilolystesis
 Overall clinical results are good; there’s no significant difference in
clinical outcome between XLIF + ILIF and other circumferential
constructs.
 Surgical time, total blood loss and hospitalization are shorter then
those observed in XLIF® + percutaneous pedicle screws or open
techniques.
 Evidence of fusion on post-op CT scan in one patient with bone
growth in intersomatic space behind Co-Roent cage; no evidence of
fusion in interspinous and interlaminar space after at least three
month after surgery.
 No evidence of subsidence of the cages with ILIF as posterior fixation
choice.