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help with XLIF versus PLIF with severe stenosis and laminectomy needed

Started by maguy on 08/03/2015 12:42pm

I hope that someone has some experience with this dilemma. I have severe stenosis at L3-4 and grade 1 spodylolithesis and bad disc due to congenital stenosis. My question is what it the best approach for me. All surgeons agree that I need a fusion at L3-4 followed by laminectomy for severe stenosis. Both do both approaches( XLIF and PLIF) and operate both minimally invasive and open when needed , but the second opinion surgeon felt that unless I had an open posterior approach, that I would not get enough relief from leg pain because it would not be possible to open up the canal enough using a minimally invasive approach to do the laminectomy. He also felt that the laterally place cage for the fusion would not be adequate( used in XLIF) and that I should have a posteriorally placed cage for the fusion( both agree that I will need rods and screws placed during the posterior procedure). I was hoping to not have to have an open surgery but now I am not sure what is the best way to go. The surgeon who suggested the XLIF would then do a posterior minimally invasive laminectomy( not open) and place the rods and screws. Not sure what to do? Other than this issue , I am a very healthy and active person in my 50's.

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