Xlif Case Review

1. XLIF®
Case Review
Zullo Nicola M.D.

2. Male, 83 years
3 year low back pain
Failed conservative therapy
Physical exam positive for radiculopathy
(claudicatio 100 m)
Severe stenosys on MRI and
spondilolistesys L3L4 and L4-L5
No pain using bicycle
Inability to stand supine position

3. [Case #1, Pre-op]

4. [Case #1]

5. [Case #1]
L2-L3
L3-L4

6. [Case #1]
Left Foraminal view Right Foraminal view

7. [Case #1]
L3-L4
L2-L3
L4-L5

8. NRS Back 7
NRS Leg 7
ODI 47
Pre - operative

9. 3 Days post - operative

10. 3 Months post - operative

11. NRS Back 2
NRS Leg 4
ODI 9
3 Months post - operative

12. 6 Months post - operative

13. 6 Months post - operative
NRS Back 2
NRS Leg 2
ODI 6

15. Female, 84 years
4 year low back pain
Failed conservative therapy
Physical exam positive for
radiculopathy (claudicatio 300 m)
Severe stenosys on MRI at L4-L5
2009 Vertebroplasty L1

16. Pre - operative
NRS Back 9
NRS Leg 6
ODI 51

17. [Case #3, Pre-op]

19. Intra- operative

20. Intra- operative

21. 3 Days post - operative

22. 3 Months post - operative

23. NRS Back 5
NRS Leg 5
ODI 16
3 Months post - operative

24. 6 Months post - operative

25. NRS Back 5
NRS Leg 5
ODI 38
6 Months post - operative

27. Female, 76 years
5 year low back pain
Failed conservative therapy
Physical exam positive for radiculopathy
(claudicatio 100 m)
Stenosys on MRI and spondilolistesys L4-
L5
Diabetes
Osteoporosis

28. Pre - operative
NRS Back 7
NRS Leg 8
ODI 49

31. PI 53°
PT 19°
LL 71°

37. 3 Days post - operative

38. 3 Months post-operative

39. 3 Months post-operative
NRS Back 3
NRS Leg 3
ODI 12

41. Male, 43
10 year low back pain with
some radicular left leg pain
Failed conservative therapy
Physical exam negative for
radiculopathy
No root compression on MRI
No comorbidities

42. Pre - operative
NRS Back 8
NRS Leg 4
ODI 34

47. 3 Days post - operative

48. 1 month post-op

49. 3 months post-op

50. 3 Months post - operative
NRS Back 1
NRS Leg 1
ODI 18

51. • Male 42 YO, obesity, building
industry worker
• two years low back pain with right
mild L5 raduclopaty
• Failed conservative therapy
• L4-L5 Degenerative disc disease
Modic 2 Pfirrmann IV with associated
spinal canal narrowing
• No clear nerve root compression on
MRI
• Physical exam: mild right
radiculopaty, sever low back pain
• No significant co-morbidities

52. Pre-operative assessment
NRS back 8
NRS Leg 2
ODI 32/50

53. Pre-operative imaging

54. Pre-operative imaging
L4-L5 L5-S1

55. SPINO-PELVIC ASSESSMENT
PT 40°
PI 20°
LL 12°
C7 PL midpoint S1 plate

56. 1 month post-op X-ray

57. Three months CT scan

58. Three month post-op. assessment
NRS Back 1
NRS Leg 0
ODI 0/50