Acta Neurochirurgica (2025) 167:221
This review evaluates the use of Extreme Lateral Interbody Fusion (XLIF) for removing failed spinal implants. XLIF offers advantages over traditional approaches, including reduced operative risk, blood loss, and hospital stay, but requires surgical expertise due to potential nerve and vascular complications.
• XLIF (Extreme Lateral Interbody Fusion) is increasingly used for spinal revision surgery to remove failed interbody implants and other foreign bodies.
• A systematic literature review identified only a few published cases (seven documented, four included) using XLIF for this purpose.
• XLIF offers advantages over anterior and posterior approaches, including reduced operative time, less blood loss, shorter hospital stays, and safer navigation around scar tissue and neurovascular structures.
• The technique allows for insertion of larger interbody cages, improving spinal stability and fusion outcomes.
• Most reported complications are minor and transient, such as temporary nerve injury, but careful patient selection and surgical expertise are required.
• XLIF is especially valuable in complex revision cases where traditional approaches pose higher risks due to scar tissue or anatomical challenges.
• Current evidence is limited to case reports and small series; more robust studies are needed to validate safety and efficacy.
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