Inspired MIS-DLIF

For the unfortunate individuals who experience chronic back pain and fail conservative treatment, surgery may become necessary for relief. Lumbar interbody fusion is a common surgical treatment.backpain


Over the last few decades, there have been several spinal fusion procedures used by surgeons, with different angles approaching the degenerative disc space. Variations include:

  1. Directly posterior (from the back) = Posterior Lumbar Interbody Fusion (PLIF)
  2. Oblique Angle Option #1 – Transforaminal Lumbar Interbody Fusion (TLIF)
  3. Directly Anterior – Anterior Lumbar Interbody Fusion (ALIF)
  4. Anterior and Posterior variation
  5. Oblique Angle Option #2 – Oblique Lateral Lumbar Interbody Fusion (The Inspired Spine OLLIF)
  6. Direct Lateral – Direct Lateral Interbody Fusion (XLIF)


While the XLIF procedure has overall been a great procedure due to the approach from the side, there are limitations. It is difficult to perform the procedure at the lowest level of the lumbar spine due to the pelvis blocking the instrumentation, and also tough in the upper lumbar region because of the ribs blocking. In addition, once the interbody fusion cage is placed the patient requires patient repositioning in order to place the supplemental screws.


The XLIF procedure is really an open procedure with direct visualization. This tends to disrupt connective tissue and muscles, increasing post-operative pain and hospital stay.


The most recent approach for lumbar interbody fusion is a minimally invasive keyhole approach to the Direct Lateral Interbody Fusion. It is known as the minimally invasive keyhole spine direct lateral interbody fusion, or MIS-DLIF for short. Inspired Spine has developed the technique in a successful effort to push the envelope of minimally invasive keyhole, safe and effective advancements in spinal fusion surgery.


The difference from the XLIF relates to a few key issues:

  1. Truly minimally invasive keyhole using two C-Arms (x-ray machines) rather than direct visualization.
  2. No issue being performed at either L5-S1 levels or T12-L1.
  3. Procedure does not require removal of spinal joints.


With the MIS-DLIF procedure, patients experience less bleeding, decreased hospital stay and a quick recovery. In a 9 patient pilot study, half the patients were discharged same day, and the rest stayed overnight. For a major spinal fusion procedure, this is remarkable.