Mark Santman, M.D.

Surgery of the Adult Spine in Round Rock, TX


Direct Lateral Fusion (DLIF, XLIF & LLIF)

A direct lateral interbody fusion can be performed for a variety of thoracic and lumbar spine conditions including disk herniations, lumbar spinal stenosis, spondylolisthesis, scoliosis and radiculopathy (nerve root injury).

The surgery can be divided into three basic steps:
1. Removal of the disk between the vertebrae,
2. Fusion of vertebrae with a cage and bone graft,
3. Stabilization of the fusion with metal plate and screws.

The lateral interbody fusion is different from other fusions because the discectomy, fusion and stabilization are performed from the side. This approach results is a reduction of blood loss, decreased length of hospital stay, faster recovery time and a decreased risk of chronic back pain after surgery.


The surgery is performed through two small skin incisions on the patient’s right or left side.   A narrow tube is gently inserted through the soft tissue under fluoroscopy (x-rays) with the aid of a minimally invasive muscle retracting system. This retractor minimizes damage to the muscles, soft tissue and nerves and is performed in conjunction with electrical monitoring of the nerves in the legs. With the aid of fiber optic technology, the disk can be removed with specially-designed surgical instruments.  The interbody fusion is performed by placing a cage (hollow spacer) packed with bone into the disc space. This cage maintains disc space height and allows bone cells to grow from one vertebra to another. After the diskectomy and fusion are completed, a metal plate and screws may be placed over the cage, graft and vertebra to stabilize the spine during the fusion (healing) process. If a lateral plate and screws are not used, metal rods and screws may be surgical placed into the bone through separate skin incisions (Dr. Santman would discuss and recommend before surgery). The skin is closed using dissolvable sutures and sterile superglue. Some patient’s may require a back brace after surgery.
We are proud to provide leading-edge spine surgery service to the people of Austin, Round Rock, Georgetown, Cedar Park, Pflugerville, Taylor, Hutto, Lakeway, Elgin, Leander, Liberty Hill, Granger, Llano, Bastrop and the Texas Hill Country.

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