Citation, DOI, disclosures and article data
Citation:
Gaillard F, Campos A, Knipe H, et al. Lateral lumbar interbody fusion (LLIF). Reference article, Radiopaedia.org (Accessed on 21 Mar 2025) https://doi.org/10.53347/rID-59808
Lateral lumbar interbody fusion (LLIF), also commonly known by the proprietary names eXtreme Lateral Interbody Fusion (XLIF) or Direct Lateral Interbody Fusion (DLIF) 3, is one of many approaches to lumbar interbody fusion and is performed from T12/L1 to L4/5.
See: lumbar interbody overview (overview).
L5/S1 operative level (iliac crests block lateral access)
prior extensive retroperitoneal surgery
sacralized L5 when operating at L4/5
osteoporosis (relative) 4,5
Unlike an ALIF, an LLIF is performed from a lateral transpsoas approach and does not require retroperitoneal or intraperitoneal dissection. The disc space is reached and a discectomy is performed. Into the defect is introduced a disc spacer cage and bone and/or graft material that will, in time, result in complete bony fusion 1,2.
The newer XLIF and DLIF techniques allow a minimally-invasive approach. Neuromonitoring can be used in the XLIF technique 4.
Anterolateral screwed plates, posterior transpedicular instrumented fusion and posterior decompression can also be performed if indicated 6,7.
ADVERTISEMENT: Supporters see fewer/no ads
History and etymology
This technique was developed in the early 2000s to be a safer alternative to the older anterior lumbar interbody fusion (ALIF), which was developed in the 1950s 1,2.
-
1. Ozgur BM, Aryan HE, Pimenta L, Taylor WR. Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. (2006) The spine journal : official journal of the North American Spine Society. 6 (4): 435-43. doi:10.1016/j.spinee.2005.08.012 - Pubmed
-
2. Berjano P, Gautschi OP, Schils F, Tessitore E. Extreme lateral interbody fusion (XLIF®): how I do it. (2015) Acta neurochirurgica. 157 (3): 547-51. doi:10.1007/s00701-014-2248-9 - Pubmed
-
3. Salzmann SN, Shue J, Hughes AP. Lateral Lumbar Interbody Fusion-Outcomes and Complications. (2017) Current reviews in musculoskeletal medicine. 10 (4): 539-546. doi:10.1007/s12178-017-9444-1 - Pubmed
-
4. David S. Xu, Corey T. Walker, Jakub Godzik, Jay D. Turner, William Smith, Juan S. Uribe. Minimally invasive anterior, lateral, and oblique lumbar interbody fusion: a literature review. (2018) Annals of Translational Medicine. 6 (6): 7. doi:10.21037/atm.2018.03.24
-
5. Ralph J. Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J. Rao. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. (2015) Journal of Spine Surgery. doi:10.3978/j.issn.2414-469X.2015.10.05
-
6. Lee Y, Park S, Kim Y. Direct Lateral Lumbar Interbody Fusion: Clinical and Radiological Outcomes. J Korean Neurosurg Soc. 2014;55(5):248-54. doi:10.3340/jkns.2014.55.5.248 - Pubmed
-
7. Allain J & Dufour T. Anterior Lumbar Fusion Techniques: ALIF, OLIF, DLIF, LLIF, IXLIF. Orthopaedics & Traumatology: Surgery & Research. 2020;106(1):S149-57. doi:10.1016/j.otsr.2019.05.024 - Pubmed
Promoted articles (advertising)
Unable to process the form. Check for errors and try again.