ABSTRACT Lumbar hernia following extreme lateral interbody fusion (XLIF) with iliac crest bone harvest is an uncommon but clinically relevant complication. A man in his 70s presented with left flank discomfort and a bulge 3 years after XLIF for lumbar spinal canal stenosis, performed via a route using the left anterior superior iliac spine. CT showed herniation of the descending colon through an abdominal wall defect. Laparoscopic intraperitoneal onlay mesh repair was undertaken with nerve‐sparing fixation. Recovery was uneventful, and no recurrence or postoperative neuropathic pain was observed at 6 months. This case underscores the potential for abdominal wall weakening when XLIF is combined with iliac crest harvest and the value of laparoscopic repair with nerve‐sparing fixation. Meticulous fascial closure and long‐term follow‐up may reduce the risk of delayed lumbar hernia.
Kusunoki et al. (2026) studied this question.