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Orthopaedic Surgery American Academy of Orthopaedic Surgeons Clinical Faculty Olympia Medical Center Cedars Sinai Medical Center Century City Doctors Hospital Education The University of California, Los Angeles The University of Michigan, Ann Arbor
The procedure is called eXtreme Lateral Interbody Fusion because the approach is made from the lateral aspect of the patient, i.e. the side/flank
Using Xrays in surgery, Dr Pazmino marks out two tiny incisions on the patients left flank with a pen
Here you can see how Dr Pazmino and his team operate while the patient is on the side The Xray machine is critical in keeping this a minimally invasive procedure. Here you can see the machine is labeled “Fluoro”.
Dr Pazmino then creates two tiny incisions on the patient’s left side Dr Pazmino then places a probe through one incision and uses this to guide his instruments away from neuromuscular structures.
These two small incisions are all Dr Pazmino requires to access the disc spaces
Here we see the Probe guiding Dr Pazmino away from the neural structures The beauty of this procedure is that it allows Dr Pazmino to completey detect and avoid the nerves which lie along the side of the spine.
Now using Xrays in the OR Dr Pazmino is able to guide the same probe into the damaged disc of the spine
Dr Pazmino next uses dilators over the probe and opens the space in a minimally invasive manner where he plans to perform the surgery
Here we can see how Dr Pazmino places dilators of increasing size over the probe.
Now Dr Pazmino has set the final Dilation necessary to perform the entire XLIF procedure
This is what it looks like on Xray once Dr Pazmino is at the correct level You can see the probe is inside the disc space
Now that Dr Pazmino has obtained the exact opening he requires to perform the XLIF he is able to insert a Retractor in a minimally invasive manner .  The retractor is inserted over the dilation tubes and probes
You can see how the retractor gives Dr Pazmino direct access to the disc space from the lateral position This retractor is helpful in avoiding nerves and trauma to muscles
At this point Dr Pazmino removes the degenerated disc is identified through the retractor.
At this point Dr Pazmino removes the degenerated disc is through the retractor, and prepares the area for the XLIF.
Next Dr Pazmino sizes the disc space for the desired implant in terms of height, angulation, and depth.
A bony spacer implant, plastic or metal cage is filled with BMP, or bone graft and slid into the disc space. This will indirectly relieve pressure from pinched nerve roots
Dr Pazmino next closes the retractor, and removes all surgical instrumentation.
With the retractor closed Dr Pazmino can then safely remove it from the small incisions Dr Pazmino now prepares for final plastic surgical closure
The bone inside the spacer then will grow through the spacer, around the spacer and connects the vertebral bodies above and below. Once solid this bony union is called a fusion.
 
All our procedures are performed in  a minimally invasive manner. All patients receive a plastics closure and are followed closely afterwards
Thank you for your time. If you know someone who could benefit from a consultation for XLIF please refer them to our online website or call toll free to schedule an appointment 1-8SPINECAL-1 www.beverlyspine.com www.santamoincaspine.com

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XLIF by Pablo Pazmino MD

  • 1.  
  • 2. Orthopaedic Surgery American Academy of Orthopaedic Surgeons Clinical Faculty Olympia Medical Center Cedars Sinai Medical Center Century City Doctors Hospital Education The University of California, Los Angeles The University of Michigan, Ann Arbor
  • 3. The procedure is called eXtreme Lateral Interbody Fusion because the approach is made from the lateral aspect of the patient, i.e. the side/flank
  • 4. Using Xrays in surgery, Dr Pazmino marks out two tiny incisions on the patients left flank with a pen
  • 5. Here you can see how Dr Pazmino and his team operate while the patient is on the side The Xray machine is critical in keeping this a minimally invasive procedure. Here you can see the machine is labeled “Fluoro”.
  • 6. Dr Pazmino then creates two tiny incisions on the patient’s left side Dr Pazmino then places a probe through one incision and uses this to guide his instruments away from neuromuscular structures.
  • 7. These two small incisions are all Dr Pazmino requires to access the disc spaces
  • 8. Here we see the Probe guiding Dr Pazmino away from the neural structures The beauty of this procedure is that it allows Dr Pazmino to completey detect and avoid the nerves which lie along the side of the spine.
  • 9. Now using Xrays in the OR Dr Pazmino is able to guide the same probe into the damaged disc of the spine
  • 10. Dr Pazmino next uses dilators over the probe and opens the space in a minimally invasive manner where he plans to perform the surgery
  • 11. Here we can see how Dr Pazmino places dilators of increasing size over the probe.
  • 12. Now Dr Pazmino has set the final Dilation necessary to perform the entire XLIF procedure
  • 13. This is what it looks like on Xray once Dr Pazmino is at the correct level You can see the probe is inside the disc space
  • 14. Now that Dr Pazmino has obtained the exact opening he requires to perform the XLIF he is able to insert a Retractor in a minimally invasive manner . The retractor is inserted over the dilation tubes and probes
  • 15. You can see how the retractor gives Dr Pazmino direct access to the disc space from the lateral position This retractor is helpful in avoiding nerves and trauma to muscles
  • 16. At this point Dr Pazmino removes the degenerated disc is identified through the retractor.
  • 17. At this point Dr Pazmino removes the degenerated disc is through the retractor, and prepares the area for the XLIF.
  • 18. Next Dr Pazmino sizes the disc space for the desired implant in terms of height, angulation, and depth.
  • 19. A bony spacer implant, plastic or metal cage is filled with BMP, or bone graft and slid into the disc space. This will indirectly relieve pressure from pinched nerve roots
  • 20. Dr Pazmino next closes the retractor, and removes all surgical instrumentation.
  • 21. With the retractor closed Dr Pazmino can then safely remove it from the small incisions Dr Pazmino now prepares for final plastic surgical closure
  • 22. The bone inside the spacer then will grow through the spacer, around the spacer and connects the vertebral bodies above and below. Once solid this bony union is called a fusion.
  • 23.  
  • 24. All our procedures are performed in a minimally invasive manner. All patients receive a plastics closure and are followed closely afterwards
  • 25. Thank you for your time. If you know someone who could benefit from a consultation for XLIF please refer them to our online website or call toll free to schedule an appointment 1-8SPINECAL-1 www.beverlyspine.com www.santamoincaspine.com