Anterior Lumbar Interbody Fusion
An anterior lumbar interbody fusion (ALIF) is a surgical procedure used to treat a damaged or diseased disc that is causing lower back pain and/or leg pain.
The distinguishing feature of an ALIF is the approach—a 3-5-inch incision is made over the front or side of the stomach (an anterior incision) instead of over the lower back (a posterior incision). Since the anterior abdominal muscle in the midline (rectus abdominis) runs vertically, it does not need to be cut and easily retracts to the side.
The abdominal contents lay inside a large sack (peritoneum) that can also be moved out of the way, thus allowing the spine surgeon access to the front of the spine without actually entering the abdomen.
This type of approach is advantageous because:
- The back muscles and nerves experience less trauma
- The surgeon has direct access to the affected disc
- A much larger implant can be inserted through an anterior approach
Because large blood vessels (aorta and vena cava) that continue to the legs lay on top of the spine, a vascular surgeon typically assists with the approach.
Once the spine is accessible, the spine surgeon follows a step-by-step process to remove and replace the pain producing disc.
1. The disc is removed. Tiny instruments are used to partially remove the disc. The disc wall is left behind to help contain bone graft.
2. The disc is replaced. A metal cage implant filled with bone graft is placed in the opened space and against the disc wall. The lumbar vertebrae realign and pressure is lifted from pinched nerve roots.
3. The spacer is fix in place. Surgical screws, rods, and/or plates are used to hold the cage in place so the bone graft can form solid bone bridge that fuses the vertebrae.
The entire procedure typically takes 1-3 hours. After surgery, a 1-3-day hospital stay is typically necessary.
Following a successful Anterior Lumbar Interbody Fusion (ALIF) procedure, bone healing and growth fuse the vertebrae together. Because the diseased and/or damaged disc is replaced with strong, solid bone, lower back pain and/or leg pain decreases.
An ALIF may be recommended when conservative, non-surgical treatment options do not decrease the symptoms of:
Non-smoking patients who are in good medical condition are candidates for the ALIF procedure.