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XL TDR® - eXtreme Lateral Total Disc Replacement
A Study Investigating Minimally Disruptive Motion Preservation for the Lumbar Spine.
Disclaimer
The materials on this Web site are for your general educational information only. Information you read on this Web site cannot replace the relationship that you have with your healthcare professional. We do not practice medicine or provide medical services or advice as a part of this Web site. You should always talk to your healthcare professional for diagnosis and treatment.
Know Your Options
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Due to advances in medical technology, patients suffering from pain due to degenerative conditions now have more options than ever before. Each option has its own set of risks and benefits. Your doctor may first attempt to address your problem non-surgically; however, if that does not relieve your pain, surgery may be suggested. |
Conservative Treatment Options
Before considering back surgery, non-surgical treatments can provide good results for patients suffering from back pain. Be sure to talk with your physician about these therapies before you begin.
Heat
By dilating the blood vessels, heat therapy improves the supply of oxygen that the blood takes to the back. Heat also alters the sensation of pain. Heat therapy is generally used for chronic injuries or those with no inflammation or swelling, such as muscle spasms or sore, stiff, nagging muscle pain.
Medications
Back pain can be alleviated by over-the-counter or prescription medications, such as muscle relaxants, narcotics, nonsteroidal anti-inflammatory drugs (NSAIDs/NSAIAs), or acetaminophen. Talk with your doctor to see which medication might be right for you.
Exercise
An effective approach to managing back pain is exercise. Generally, some form of consistent stretching, strengthening exercise is believed to be an essential component of most back treatment programs.
Physical Therapy
For some back pain, physical therapy may be prescribed. A physical therapist will assist with the use of exercises and physical activities to help condition muscles and restore strength and movement. Length and type of treatment depend upon the severity of the condition.
Massage
With the help of a trained professional, massage therapy may help. Before starting treatment, your therapist should ask detailed questions about your injury and the location of the pain in order to determine which therapy is best.
Acupuncture
A consensus panel convened by the National Institutes of Health (NIH) in 1997 concluded that acupuncture might be effective when used as part of a comprehensive treatment plan for low back pain, among other conditions.
Surgical Treatment Options
Once your doctor has recommended spine surgery, the next step is deciding which surgical procedure is appropriate for you. Surgery to reduce pain and restore function to the back sometimes requires stabilization of two vertebrae. This is done to reduce motion between the joints, adjust alignment, and restore disc height. This type of procedure is called an interbody fusion and generally speaking, is defined by the “approach,” or the way in which the surgeon accesses the spine.
Interbody Fusion
Traditionally, there are a few ways to fuse the spine. One of these ways is known as interbody fusion, which is fusion of two vertebrae between the vertebral bodies (main trunk of the vertebrae) in the anterior column (front part of the spine). In order to fuse two vertebrae together using interbody fusion, the intervertebral disc must first be removed. In the space created by the removal of the disc, an implant, such as a spacer or cage, will be inserted to help maintain the normal alignment of the spine. Additionally, bone graft (real pieces of bone used to stimulate bone growth) or bone graft substitute (natural or synthetic material used to replace bone tissue and stimulate bone growth) is placed in the space made between neighboring vertebrae to help them fuse together.
In some cases, for additional stability, it will be necessary for your surgeon to implant screws, plates, or rods into the vertebrae to hold them in place.
Traditional Approaches
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Anterior Lumbar Interbody Fusion (ALIF)
In this procedure, the spine is accessed from the front of the body. This approach requires delicate manipulation of the major blood vessels in front of the spine. |
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Posterior Lumbar Interbody Fusion (PLIF)
This procedure is performed through the middle back, which allows direct access to the area being treated. The downside is that this approach also requires significant disruption to the muscles, bones, and ligaments of the back, which can lead to pain and desensitization after surgery. |
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Transforaminal Lumbar Interbody Fusion (TLIF)
This approach is similar to PLIF, the difference being that only one side of the back is accessed and affected. As with PLIF, significant disruption to the muscles, bones, and ligaments of the back can occur - although limited to one side of the back. |
Thoracotomy
This procedure approaches the thoracic spine from the side of the rib cage and requires a large incision and deflation of the lung.
The XLIF® Approach
eXtreme Lateral Interbody Fusion (XLIF)
The XLIF procedure allows the surgeon to perform interbody fusion through an incision in the side of the body as opposed to the traditional incision in the front of the body. This is made possible by the use of special tools (dilator and retractor system: MaXcess® by NuVasive,® Inc.) that allow the surgeon to reach the spine via lateral access (from the side of the body). This is beneficial as it avoids major organs and vessels. In order to reach the spine via a lateral approach, only the lateral muscles are bluntly and gently separated along their fibers. This avoids cutting or tearing the muscle.
It is important that you discuss the potential risks, complications, and benefits of XLIF® with your doctor prior to receiving treatment, and that you rely on your physician’s judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.