PCrane... welcome to the forum! Sorry you find yourself needing revision surgery.
Using the terms from your post, is the 'original surgeon' highly experienced with XLIF? (how many?)
Is the surgeon who wants to do an XLIF something of an XLIF wizard? (Again, how many?)
Surgery is a compromise. XLIF is great, but as most less invasive approaches are... it is a compromise. How well can they see? How effectively can they use thier tools? Can they reach everything they need to? They certainly can't access as much with an XLIF as they can with an ALIF. (Open anterior approach.) Are the compromises relevant to your case?
I'd certainly ask the guy who wants to use XLIF for the revision, not only how experienced is he with XLIF, but how experienced is he with 2-level XLIF in a partial union kind of revision?
This is a tough call and you are going to have to make the decision and live with the results.
Are you a smoker? If so... quit! Your life depends on the fusion. Will the surgeon use BMP? What are the trade-offs with BMP (risks versus greater chance of fusion), and how are they changed with the revision you need? I would think there would be a higher risk tolerance in the revision surgery... with one non-union already.
Is Fabien Bitan one of the surgeons? If not, is he an option for you?
Fabien Bitan, M.D. - Home
Let us know how your decision making process goes. Contact me via the GPN website linked below if you want to talk.
Mark