Lateral Lumbar Interbody Fusion (LLIF or XLIF)

A procedure where damaged herniated disc and arthritic bone is removed and substituted with a spacer. This is meant to remove the pressure off the nerve and spinal cord, and stabilize the painful motion in the vertebrae from above and below.

This is done through the side of the abdomen (laterally).

This can be done at 1 or multiple levels.

  • After anesthesia is given, the patient is laid on their side.

    An incision is made on the side of the belly. Special dilators and and retractors are placed through the hip flexion muscle (psoas muscle). The spine is directly accessed from the side.

    The injured disc is removed, and the nerves are carefully relieved of the damaging pressure.

    A spacer is placed. This is repeated at multiple levels as needed. Sometimes a plate is placed on the front of the bone to stabilize the spacer.

    Intraoperative X-rays are done to confirm placement, and the wound is checked for bleeding and the incision is sutured closed.

    Sometimes screws are added through the back of the spine to further stabilize the levels.

    1. Take away the painful motion

    2. Decompress the nerves

    3. Accomplish a successful fusion

  • Depending on medical history, age, and surgical extent, some patients may spend one or multiple nights in the hospital for therapy and pain control.


    Soreness from the incision site can remain for a week or two. Muscles can spasm from surgery as they do not like getting pushed around. Nerve relief can be felt within days. The low back can feel sore, but it’s a different type of discomfort that before surgery.


    Sometimes people can have hip pain/weakness that can take up to 6 weeks to resolve. This is because surgery is done through the hip flexion muscle.


    The fusion process may take up to 12 weeks for bone graft to consolidate, but symptoms typically improve much sooner.

    Return to work times vary, some people are able to return to light work 2 week after surgery. For those with a very physically demanding job, return to work may not happen until 6-12 weeks after surgery.

    1. Relieve 50% of the back pain

    2. Relieve 70% of the leg pain

  • There is no surgery without risks. They include but are not limited to: bad reaction to anesthesia, injury to the major vessels in the belly, hip weakness, hip pain, injury to intestines, surgical site infection, prolonged pain, nerve injury, implant failure, failure of fusion, spinal fluid leak, and the need for additional surgery.