Anterior Lumbar Interbody Fusion Surgery

Anterior Lumbar Interbody Fusion Surgery

Anterior Lumbar Interbody Fusion (ALIF) is a surgical procedure performed to treat certain conditions affecting the lower spine, particularly the lumbar region. It is a type of spinal fusion surgery that aims to relieve pain and instability by fusing together two or more vertebrae in the lumbar spine.

During an ALIF procedure, the surgeon makes an incision in the abdomen, typically on the left side. This approach allows access to the front (anterior) of the spine, where the intervertebral disc is located. The damaged or degenerated disc is removed, creating a space between the adjacent vertebrae. To restore stability and promote fusion, a bone graft or a cage filled with bone graft material is inserted into the disc space. The bone graft encourages the growth of new bone, which eventually fuses the vertebrae together.

Next the the patient flipped and a posterior laminectomy and secondary fusion is performed in your back with screws and rods. When the two procedures are performed, it is referred to as a 360 fusion with a fusion in the disc space and a fusion in the facet joints with screws and rods.

ALIF surgery is commonly performed to address conditions such as degenerative disc disease, spondylolisthesis (slipped vertebrae), and spinal instability. By fusing the vertebrae, the procedure aims to alleviate pain, improve stability, and potentially correct any deformities or spinal misalignments.

Treat Back Pain with ALIF

An ALIF is usually preferred in situations where access to the front of the spine is closed off from the back. This can include conditions that cause narrowing in the spinal canal or vertebrae misalignment, such as:

ALIF can also treat a failed posterior lumbar interbody fusion (PLIF) — a similar surgery with an approach from behind.

Who Is a Good Candidate for ALIF?

As with most surgeries, the patient must be cleared before undergoing the procedure. The significant indicator of the need for ALIF is if all other non-surgical approaches have been exhausted. These treatments can include physical therapy, medications or steroid injections.

An ALIF candidate must also show signs of instability, weakness and pain that are not responsive to conservative treatments.

ALIF is typically recommended for individuals who meet certain criteria, and the decision to undergo this procedure is made on a case-by-case basis by a qualified healthcare professional. However, here are some general factors that may make someone a good candidate for ALIF:

  • Degenerative Disc Disease: ALIF is commonly used to treat degenerative disc disease, a condition characterized by the breakdown of spinal discs, leading to pain and instability.
  • Disc Herniation: If a lumbar disc herniates and causes significant pain, weakness, or numbness, ALIF may be considered to alleviate symptoms and stabilize the spine.
  • Spinal Instability: ALIF can be beneficial for individuals with spinal instability due to conditions such as spondylolisthesis (where one vertebra slips forward over another) or scoliosis (abnormal curvature of the spine).
  • Failed Conservative Treatments: When non-surgical treatments like physical therapy, medications, and injections have failed to provide relief, ALIF may be considered as a surgical option.

Before and After an ALIF Surgery

ALIF is a minimally invasive procedure with excellent results for the ideal candidates. Learn more about this procedure’s general preoperative, surgical and postoperative methods.

Before surgery, a doctor will request preoperative testing to ensure proper qualifications are met. This testing will likely be in the form of a medical physical, involving blood work and other various tests to ensure your body can undergo anesthesia and surgery. Once cleared, the patient will need to ease off habits such as smoking and drinking, which could interfere with proper healing following surgery. It is also recommended to refrain from taking any NSAIDs like Aspirin or Advil for pain, as these can thin the blood and cause potential complications. The patient will be asked not to eat or drink anything after midnight the night before. Be sure to communicate with a surgeon about any allergies, medications or current health conditions that could affect the surgical outcomes.

Once the patient is taken to the operating room, the medical staff will start an IV to provide them with fluids and medications to make them sleepy. ALIF is done under general anesthesia. Once the anesthesia has been given, the patient is placed on their back on the operating table. The surgical technique is done through an incision in the abdomen muscles, retracting (moving) the intestines, and large blood vessels to expose the anterior — or front — of the spine and verterbal disc. The advantage of this approach is it avoids spinal nerve retraction and therefore decreases risk of neurologic injury. In some cases, the surgeon may do what they call a 360 fusion. After the disc is removed and replaced with a bone graft, the incision is closed. The operating team then will flip the patient over onto their stomach and the surgeon will place pedicle screws and rods through two small incisions in the back for a secondary fusion.

Patients tend to stay in the hospital for one or two nights as medical professionals monitor the patient and ensure no complications are present. The patient will need to be able to walk and perform daily living activities on their own — going to the bathroom, eating, brushing their teeth and dressing — before being discharged from the hospital.

ALIF Risks and Complications

The primary concern with ALIF is that the added bone graft will not successfully fuse with the rest of the vertebrae, therefore not providing the wanted pain relief.

This outcome can be enhanced by carefully following your surgeon’s recommendations. Wearing your back brace, not smoking, and eating healthy can also ensure the fusion takes place.

Other potential complications include:

The impact that the surgery may have on the bowels can affect typical stool patterns, which can subsequently influence the patient’s ability to eat solid food. Constipation only occurs in a small portion of patients and can resolve on its own.

As with every surgery, an infection is possible at the incision site. Continue to properly clean the incision even after going home.

A hernia can occur during the healing process, as abdominal tissue can protrude outward.

DVT can develop through the presence of a blood clot in the lower extremities.

All surgical procedures come with a risk of extreme blood loss, but this is uncommon at the hands of experienced professionals.

The Recovery Process

A recovery and exercise plan may be given to the patient to encourage movement and strengthening during a six- to 12-week period after surgery.

Keep in mind that the vertebrae are not completely fused to the bone graft in surgery. Instead, complete fusion can take up to 12 months. Schedule several follow-up appointments to make sure proper healing occurs.

Advantages of Choosing ALIF

Choosing ALIF comes with a series of advantages for the patient. Benefit from:

  • Direct access to the front of the spinal column for more effective treatment.
  • Undisturbed back muscles and nerves, preventing nerve damage and spasms.
  • The option of using screws or rods to hold the bone graft in place.
  • A larger spinal implant for enhanced stability and spinal support.
  • More efficient and natural restoration of the spine’s curvature.
Dr. Abrams laughing

Contact DISC Today for ALIF Treatment in Arizona

Anterior lumbar interbody fusions have benefitted numerous patients and their back pain for years. At the Desert Institute for Spine Care, we are passionate about providing practical solutions to help you return to your favorite activities. For more information or to schedule an appointment, contact us today.


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