ALPA Approach or XLIF?

[Tim]

Hi all

Here are some intresting links regarding XLIF - if they've been posted before then apologies..

1. Recorded movie of live XLIF procedure at or.com :
http://www.or-live.com/tgh/2330/#

2. Experience and Early Results with a Minimally Invasive Technique for Anterior Column Support Through eXtreme Lateral Interbody Fusion (XLIF®):
http://www.touchbriefings.com/pdf/2814/rodgers.pdf

3. Charité lumbar artificial disc retrieval: use of a lateral minimally invasive technique:
http://thejns.org/doi/pdf/10.3171/spi.2006.5.6.556

OK - so if outcome success is largely dictated by surgeon experience how many procedures is enough to become proficient and who are the surgeons who are good at this now?

All the best
Tim

[ans]

Thank you for this information! - Allan

[Roblin]

Great information! Who is the most experienced surgeon in the States and the world at removing ProDisc L4/5 with this method?
Roblin

[mmglobal]

Roblin,

I may very well be wrong about this, but my impression is that we'd be talking about numbers that could be counted on a finger or two.

I believe that if you are talking a 2-level revision, it would be a moot point. They can't do L5-S1 with a lateral approach. The XLIF approach includes an osteomoty to remove the bone on one side of the keel. That may be easier to do with anterior approach, eliminating the need for lateral approach. Another advantage of already being there for anterior approach is that it may be possible to safely expose L4-5 enough so that the prosthesis may be removed without osteotomy.

Obviously, this comes with all the "I'm not a doctor" disclaimers... this is just my 'laypersons' understanding based on my experiences.

Mark