Because it involves accessing the spine through the patient's side, the Direct Lateral approach to interbody fusion offers surgeons and their patients a less invasive option for spine surgery.
Unless you've studied anatomy, chances are you've never heard of the psoas (soh-uhs) muscle. One of the "unsung heroes" of the body, this important muscle extends along the length of the lower spine and is responsible for stability, flexion and range of motion in the lower back and hips.
Precisely because of its location, it's also an integral part of a minimally invasive spinal fusion procedure that's been gaining favor in the orthopedic community in recent years. Called direct lateral interbody fusion (DLIF), this approach to spinal fusion allows access to the area to be treated while potentially minimizing disruption of the surrounding soft tissues and anatomical structures.
The DLIF procedure is different from other interbody fusion techniques in that to approach the spine, Dr. Ismail makes a small incision in the skin of the patient's side. Then, using minimally invasive surgical techniques, he creates a narrow passageway through the underlying soft tissues and the psoas muscle — gently separating the fibers of the psoas muscle rather than cutting through it — directly to the vertebra and disc to be treated. This is called the trans-psoas, or Direct Lateral, approach to interbody spinal fusion.
DLIF is one of several minimally invasive spine procedures available today. Other procedures, such as minimally invasive decompression or minimally invasive TLIF, may be recommended depending on your condition. The potential benefits of minimally invasive may include:
However, even though DLIF is a minimally invasive procedure, it's important to remember that it is still spine surgery, and therefore not without risk. Potential risks associated with surgery include anesthesia complications, blood clots, allergic reactions and adverse effects due to undiagnosed medical problems, such as silent heart disease.
For a minimally invasive DLIF procedure, the patient is positioned on their side on the operating table — this is called the lateral decubitus position — and sedated under general anesthesia. Dr. Ismail then:
Places pedicle screws and rods in the patient's back using the minimally invasive CD HORIZON® SEXTANT® System. This instrumentation is intended to provide additional stabilization while the bone heals or "fuses".