According to Technavio, the LLIF market in the US mark the presence of large, well-established vendors as well as new and emerging companies. This market is subject to rapid change and over the last weeks, we have seen the launch of the Velocity Lateral Cage (Spine Wave), and 4WEB Medical announcing the FDA Clearance of their Lateral Spine Truss System.Medtronic, DePuy Synthes, and Stryker are the leading players in the market, but these players are continuously losing their market share to at least 40 smaller players.Learn about 45 Lateral Cages in:https://thespinemarketgroup.com/llif/
What are the XLIF and DLIF procedures?
The XLIF and DLIF are types Lateral Lumbar Interbody Fusion, or LLIF, which is a category of fusion in which the disc in the front of the spine is removed and replaced with an implant containing a bone graft to set up the condition for the two vertebrae to fuse together through the disc space.
XLIF uses a minimally invasive, transpsoas approach to the spine. The surgeon uses his or her finger to perform blunt dissection through a posterior paraspinal incision to escort dilators and a guide wire into position directly over the psoas muscle. Using his or her finger the surgeon is able to create a retroperitoneal space and protect the viscera and prevent possible injury.
With the DLIF technique, some surgeons have chosen to perform this procedure through a single miniopen lateral approach without the use of the posterior incision to create the retroperitoneal space. With the single incision, the layers of the abdominal wall are directly visualized, and the retroperitoneal space is created under direct vision with passage of instruments through the psoas. In addition, the use of electrophysiological monitoring, including triggered and freerunning electromyography (EMG), reduces the likelihood of injury to the lumbosacral plexus when accessing the disc space through the psoas muscle. Dilators, which contain insulated tips allow for EMG monitoring as they are introduced via the transpsoas approach to the disc space. If a dilator passes in proximity to the lumbosacral plexus, the surgeon is warned both visibly on a graphic display and also via auditory feedback. The surgeon can then adjust his or her trajectory to reduce the likelihood of neural injury.
The major advantage of XLIF/DLIF is the fact that the procedure does not require a second access surgeon. Other advantages are reduced incidence of ileus, the anterior longitudinal and posterior longitudinal ligaments remain intact, the lack of need for bony resection as performed when posterior approaches for interbody fusion are being used, reduced operative time in comparison to other anterior approaches, and reduced postoperative hospital stay and analgesic requirements. In deciding to use this approach over others, a flowchart is included to assist the reader in decision making versus other
techniques. Source; http://media.axon.es/pdf/87399_2.pdf