FLIF—Far Lateral Lumbar Interbody Fusion: Dr. Antonacci’s Approach


Minimally Invasive Spine Surgery and Muscle Sparing Approaches

Dr. Antonacci has spent years pioneering the latest techniques and improvements in spinal surgery, and has worked extensively on new less invasive, muscle-sparing approaches to interbody fusions in the lumbar spine. Contact our office to see if your spondylolisthesis, stenosis, herniated disk, degenerative scoliosis, or other spinal condition could benefit from his expertise.

M. Darryl Antonacci MD, FACS

M. Darryl Antonacci MD, FACS
Chief Spine Surgeon & Director
Specialist in Pediatric & Adult Spine

FLIF—Far Lateral Lumbar Interbody Fusion: Dr. Antonacci’s Approach

Who Should Consider Far Lateral Interbody Fusion?

Any spinal reconstruction procedure is possibly appropriate for the far lateral interbody fusion (FLIF) procedure. Patients with conditions such as low- and high-grade spondylolisthesis, scoliosis, stenosis, kyphosis, herniated disc, flatback or discogenic back pain may benefit from FLIF as a less invasive procedure. Blood loss and operative time is of special concern for patients needing spinal reconstructive surgery (*see below), therefore Dr. Antonacci’s approach is ideal for reduction of blood loss and decreased operative times.

How Does the Far Lateral Interbody Fusion (FLIF) Procedure Work?

FLIF uses a back muscle-sparing approach for accomplishing a less invasive surgery. After the skin incision, rather than cut the back muscles and dissect them away from the spine as is done in traditional or typical spinal surgeries, Dr. Antonacci uses a natural interval between the back muscles – a natural plane called the inter-muscular plane. This naturally muscle-sparing approach better protects your back muscles from the damage caused by typical spine surgery, improves recovery times dramatically, shortens hospital stays, and preserves midline structures, thereby reducing potential junctional problems in the future. In revision surgeries, it also avoids prior scar tissue planes. Because Dr. Antonacci’s technique provides excellent visualization, there is less blood loss and less risk. It allows for complete decompression of the spinal canal, complete discectomy, interbody fusion, and spinal reconstruction with less collateral damage.

What are the Advantages of Far Lateral Interbody Fusion?

Typically surgery that is less invasive will carry less risk for the patient for several reasons. In the case of the FLIF procedure, surgical time is greatly decreased, as is average blood loss during surgery. These and other factors therefore result in reduced length of hospital stay, making surgery less inconvenient for both patient and family.

Spine Surgery Patient and Parent Testimonials of Dr. Darryl Antonacci.


The FLIF approach results in decreased surgical time, blood loss, and length of hospital stay

Single level 2-3 levels > 3 levels
LOS 1-2 days 2-3 days 4 days
Surgical time 1.5 hours 2.25 hours Add 30 minutes per level > 3
Blood loss < 250 250-400 600

*Typically, one level spinal reconstruction surgeries with Dr. Antonacci’s FLIF technique have hospitals stays of 1 day, and operative times of under 1.5 hours. Spinal reconstruction surgeries with two levels have stays of 1-2 days and operative times of 1.5-2 hours; surgeries with three levels have stays of 2-3 days and operative times averaging 2.5 hours. These operative times and hospital stays for Dr. Antonacci’s patients are dramatically less than most other spinal surgeons, and represent the true benefit of his pioneering procedure and his years of experience and expertise. (Peer reviewed data at the 18th International Meeting on Advanced Spine Techniques – IMAST, Copenhagen, Denmark, July 2011)

Our Offices Are Conveniently Located in Manhattan and Central New Jersey

Have Your Spine Case Doctor-Reviewed by Nationally Renowned Spine Surgeon, Dr. Darryl Antonacci. After Doctors’s review, a staff member from Dr. Antonacci’s and Dr. Betz’s office will contact you typically within 48 hours for more information about your condition or to schedule an appointment.

Our Office Locations


Near Princeton, NJ
3100 Princeton Pike,
Bldg. 1-D
Lawrenceville, NJ 08648
Office: 609-912-1500
Fax: 609-912-1600


Upper East Side, NYC
800A Fifth Avenue,
Suite 301
New York, NY 10065
Office: 609-912-1500
Fax: 609-912-1600

NJ and NY Spine Surgery Treatment Centers

University Medical Center of Princeton (UMCP)
1 Plainsboro Road,
Plainsboro, NJ 08536
Mount Sinai Medical Center,
New York City

1 Gustave L. Levy Pl, New York, NY 10029
Saint Peter’s University Hospital,
New Brunswick, NJ

254 Easton Ave, New Brunswick, NJ 08901
Scoliosis Research Society National Board of Medical Examiners AOSpine Europe Consumers Research Council of America


Our patients have shared their experiences and gratitude with us and we invite you to read their words yourself.


Meet with the leader in minimally invasive and complex spine surgery. Ask questions of concern and learn more about your options. Dr. Antonacci is looking forward to meeting with you.


You are not alone and many others have asked similar questions you may have. Read more to understand about spine surgery through Dr. Antonacci's approach.