Lateral lumbar interbody fusion

Your consultant may recommend LLIF surgery if you have a problem with your lower back or spine that hasn’t improved with other treatments such as medication and physiotherapy.

Lateral lumbar interbody fusion can be used to treat several conditions of the lower back and spine including:

• Instability of the lumbar spine caused by previous nerve root decompression surgery 
• Pars defect: A stress fracture of the lower spine common in children and adolescents 
• Spinal stenosis: Narrowing of the spinal canal that puts pressure on the nerves 
• Degenerative disc disease: Wear and tear on the discs between the vertebrae 
• Adjacent segment disease: A complication of lumbar fusion surgery where the level above or below the fusion degenerates
• Scoliosis
• Spondylolisthesis: A condition where one of your vertebrae slips out of place 
• Spinal fracture
• Infection in the spine 
• Spinal tumour

Lateral lumbar interbody fusion has several advantages over traditional spinal surgery including:

• Shorter hospital stay 
• Faster recovery time 
• Lower risk of complications 
• Less damage to the back muscles
• Minimal scarring 
• Reduced blood loss 
• Less post-operative pain

The cost of lateral lumbar interbody fusion treatment depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

At your first consultation, you will be seen by a consultant spinal surgeon, a doctor specialising in performing operations on the spine. Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care. At your appointment, your consultant will spend time getting to know you and ask you about your symptoms, general health, any medications you are taking, and treatments you have tried previously. They will discuss your expectations for treatment and encourage you to ask any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment.

Your consultant may ask to see the results of any tests or scans you have had previously, or they may arrange them on the day. These may include an X-ray, CT scan, or MRI.

At the end of your appointment, your consultant will decide if lateral lumbar interbody fusion surgery is a suitable procedure for you based on your symptoms, diagnosis, general health and expectations for treatment. They will explain the procedure including how to prepare for surgery, what happens during the procedure, any possible risks and complications and what to expect during your recovery.

Your consultant will tell you everything you need to do to prepare for your lateral lumbar interbody fusion surgery. Instructions on how to prepare will also be in your appointment letter.

If there’s anything you’re not sure about, or if you have any questions, please contact the hospital for advice.

Pre-operative assessment

Around a week or two before your surgery, you may need to attend the hospital for a pre-operative assessment to make sure you are fit for surgery. Take any medication you take regularly with you to your appointment. At the preoperative assessment, we will check your weight and blood pressure and order tests such as a blood test, chest X-ray and electrocardiogram (ECG) to evaluate your general health.

Optimise your general health

It's important to be in the best possible health before your lateral lumbar interbody fusion surgery as this will allow your procedure to go as smoothly as possible, speed up your recovery and reduce the risk of complications after your surgery.

To ensure you are as healthy as possible before your surgery:

• Stop smoking at least eight weeks before your procedure. Smoking increases the risk of complications such as breathing difficulties and infection and can impair wound healing. Your consultant can offer you advice and support with quitting smoking before your surgery.  
• Follow a healthy, nutritious diet
• Take regular exercise
• Avoid alcohol for a few days before your surgery. Alcohol thins your blood and can increase the risk of bleeding during your operation.

Preparing your home 

You can help your recovery to go as smoothly as possible by making some preparations in advance. These may include:

• Make arrangements for someone to stay with you for a few days after your lateral lumbar interbody fusion surgery to help with household chores such as shopping, cooking, laundry and cleaning during your recovery 
• Move things you could trip over such as low tables, magazine stands, and rugs out of the way 
• Stock up on food and prepare a few meals in advance that you can freeze and heat up during your recovery
• Arrange for child and pet care if needed 
• Keep things you use regularly such as your glasses, medications, useful telephone numbers, a book and the TV remote control within easy reach

Regular medications

Your consultant may tell you to stop taking certain medications, such as blood thinners for a few days before your surgery. This is to minimise the risk of bleeding during and after your procedure.

Arriving at the hospital

You’ll be admitted to hospital the night before your lumbar lateral interbody fusion surgery. Take a shower before you arrive at the hospital, but do not apply any products to your skin such as lotions, creams, makeup or perfume. Leave any valuables and jewellery at home.

You won’t be able to eat anything for eight hours before your surgery, but you can have small amounts of water for up to four hours before.

Before your surgery, you’ll need to sign a consent form to say that you agree to have the procedure and are aware of what it entails and the possible risks and complications of the surgery.

Lateral lumbar interbody fusion is performed under general anaesthetic, meaning you’ll be asleep for the procedure.

1. Once the anaesthetic has taken effect, you will be positioned on your side and X-rays will be taken to identify the disc that needs to be removed
2. Your consultant will make an incision in your side and carefully move your muscles and organs out of the way to access your spine 
3. An instrument called a tubular retractor is inserted through the incision and used to hold the muscles open and allow your consultant a clear view of your spine
4. The diseased disc is removed and replaced with a combination of bone grafting and a metal fusion cage. In some cases, the cage is fixed into place with screws and rods inserted through another incision in your back 
5. The retractor is removed, and the incision is closed with sutures

Recovering from any type of surgery is a gradual process that is different for everyone. Recovering from lateral lumbar interbody fusion depends on several factors including your age, general health, what happened during your procedure and your individual recovery process. You can help your recovery to go more smoothly by following your consultant’s post-operative instructions carefully. Call the hospital if you have any questions or concerns.

After your lateral lumbar interbody fusion surgery, your back will probably feel stiff, and you may have some pain. Your healthcare team will give you medication to manage this. You may find sitting or standing for any length of time difficult and you will be encouraged to walk as much as possible after your surgery and throughout your recovery. Try to move or change position at least every 30 minutes. Your consultant may refer you to our expert physiotherapy team who will show you some exercises to do at home during your recovery.

You will be given instructions on how to care for your surgical wound after you go home. Your healthcare team will give you a follow-up appointment with your consultant to monitor your recovery before you leave the hospital.

How many nights will I need to stay in hospital?

You may be able to go home on the same day as your LLIF surgery, or you may need to spend one to two nights in hospital.

Will I be able to drive home?

You will not be able to drive yourself home from the hospital after your lateral lumbar interbody fusion. Please make arrangements for somebody to collect you when you are discharged.

How soon can I go back to work?

How soon you can return to work after your lateral lumbar interbody fusion surgery depends on your individual recovery and the type of job you do. If your job is sedentary, such as office work, you may be able to return to work around four to six weeks after your surgery. If you have a manual job that involves heavy lifting, or strenuous activity, you may need to take three to six months off work after your procedure.

When can I drive?

Your consultant will tell you when it is safe to drive after your LLIF surgery. For most people, this is after around two to four weeks.

When will I be back to normal?

It takes around three months for your bones to fuse after lateral lumbar interbody fusion surgery. Full healing continues for six months to a year. Most people are able to resume normal daily activities by around four to six weeks. During your recovery, try to walk a bit more each day. Listen to your body and rest if you have pain or feel tired.

Lateral lumbar interbody fusion is a generally safe procedure, but as with any type of surgery, there is a small risk that complications may occur.

Your consultant will explain all the possible risks and complications of lateral lumbar interbody fusion before your procedure and answer any questions you may have. It’s important that you are fully informed about any possible risks and complications before your procedure and are able to make an informed decision.

Possible complications of any type of surgery include:

• Adverse reactions to the anaesthetic
• Bleeding 
• Blood clots 
• Stroke 
• Infection

Possible complications specific to lateral lumbar interbody fusion include:

• Thigh pain which is usually temporary 
• The bones in your spine may not fuse properly 
• Pain at the bone graft site 
• Spinal disease may worsen or progress 
• Nerve injury which may result in sensory loss and weakness in the legs and rarely, loss of bladder, bowel, or sexual function
• Damage to nearby structures or blood vessels 
• The operation may not be successful in reducing pain and improving function

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about lateral lumbar interbody fusion book your appointment online today or call a member of our team directly on 0808 189 5499.

Lateral Lumbar Interbody Fusion - OrthoInfo

Lateral Lumbar Interbody Fusion - Globus Medical

Lumbar lateral interbody fusion: step-by-step surgical technique and clinical experience - Journal of Spine Surgery

XLIF: Lumbar Spinal Fusion - Spine Health