XLIF + ILIF ®circumferential arthrodesis as a minimally invasive

1. XLIF + ILIF ®circumferential arthrodesis as a minimallyXLIF + ILIF ®circumferential arthrodesis as a minimally
invasive fixation option: clinical results and imaging studyinvasive fixation option: clinical results and imaging study
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.