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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.
 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
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
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)
SURGICAL TECHNIQUE
FOLLOW UP
FOLLOW UP
POST-OP CT SCAN pz1
POST-OP CT SCAN pz2
POST-OP CT SCAN pz3
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.

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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)
  • 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.