Lateral/Oblique lumbar fusion

Lateral Fusion/Oblique Lumbar Fusion (Direct Lateral Lumbar Interbody Fusion-DLIF/Xtreme Lateral Lumbar Interbody fusion-XLIF/OLIF)

Oblique Lumbar Fusion


Discogenic low back pain, scoliosis, nerve impingement in the foramina causing leg pain, slipped vertebra, cancer of the spine.


This is a minimally invasive procedure. This operation is usually done from the left side of the flank/groin or chest (with patient lying in the lateral position) depending on the level of the disc being operated on. This is done using x-ray for intra-operative guidance and neural monitoring to safeguard the nerves during the operation.

After skin incision, the muscles are split and access to the disc is achieved through the retro-peritoneal fat. With direct vision, x-ray and neural monitoring, the disc is incised and removed. The empty space is filled with a cage (Titanium) with bone graft (usually artificial) within the cage. Screws can be inserted into the vertebrae, from the front or sides if indicated. After this part of the procedure, usually the patient is re-positioned in the face down position and pedicle screws are inserted through a minimally invasive method from the back to stabilize the spine.

Oblique Lumbar Fusion


  • Infection – Superficial infections are more common easily treated with antibiotics for a few days and deep infections that rarely might require removal of cages/screws.
  • Bleeding – A very small chance of significant bleeding requiring transfusion.
  • Paralysis/weakness – Due to worsening of pre-existing nerve damage or new nerve damage during the procedure – again a very small chance of significant damage.
  • Non-resolution of symptoms, especially numbness or back pain.
  • Recurrence of symptoms either due to adjacent segment disease or narrowing of foramina/spinal canal.
  • Leak of fluid from the covering of the nerves due to injury to the covering.
  • Pain in the thigh or lower abdomen due to approach – usually resolves over time.
  • Weakness of lower abdominal wall due to stretch injury of nerves.

Post-Operative Period

You would be in the hospital for a period of 5-10 days and would be encouraged to get up and walk the day after surgery. Physiotherapy would start the day after surgery and would have to continued either at home after discharge or in a rehabilitation facility.

You are allowed to lift small weights up to 5kgs but would find bending difficult during the initial 3-4 weeks. You are allowed to drive after 4-6 weeks depending on how you feel. You will be reviewed between 4-8 weeks for a follow up.

Lateral/Oblique lumbar fusion
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