ALPA Approach or XLIF?

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I had a wonderful surprise yesterday. I got a message from Dr. Bertagnoli saying that he was going to be a LAX for a 5 hour layover on his way back from the MIIST conference in Hawaii. 4 hours of his undivided attention is tough to come by... there was no problem canceling other plans (was going to see David Beckham play for LA Galaxy... 5 goal game... would have been fun, but this was better!) So instead of Dr. Bertagnoli sitting in the airport for 5 hours, I picked him up and we had a wonderful afternoon and evening. (Manhattan Beach is great!)

This post comes along with all the standard "I'm not a doctor" disclaimers. I'm just posting my layperson's recollection of our conversations. Take everything I say with a grain of salt.

Unfortunately, several of my clients are dealing with ADR revisions. I asked him a question about the XLIF approach. He corrected me... XLIF is not an approach, it's the name of some devices and is frequently used in describing systems that support the ALPA (AnteroLateral transPsoas) Approach. I didn't realize it when we were speaking, but I've seen him do it. It was truly one of the most amazing surgeries I've seen... not because of the lateral approach step, but this was a very extreme case. The ALPA approach seemed so easy, it was a very small part of this procedure. Even so... I think you'll find Ken's story is VERY interesting.

Today, I've been looking around for info on ALPA and XLIF. Both are written up in a new book that I bought at SAS last month. (Motion Preservation Surgery of the Spine, Yue, Bertagnoli, McAfee, An) This book is amazing and seems to have everything in new spine tecnologies... very well presented. Both ALPA and XLIF are written up. Bertagnoli Pioneered ALPA back in the late 90's as a minimally invasive approach for prosthetic disc nucleus implantation. It turns out that the term XLIF is frequently used to refer to the approach in addition to the hardware. In any case... ALPA, XLIF look like excellent alternatives for procedures that can be performed from these minimally invasive lateral approaches.

Whenever Dr. Bertagnoli and I get together, there is never time to just relax... we played dueling laptops as I showed him a few of the extreme clients I'm working with. It never ceases to amaze me when I will show a case to 5 different surgeons (not just a quick look... often very extensive discussions... ordering more tests... more discussions), then... showing the same case again to the same surgeons, or to a new surgeon, something JUMPS out... significant findings. That happened yesterday for a couple of clients... Dr. Bertagnoli made some incredible finds.