Surgical Information

Anterior Lumbar Interbody Fusion

What is anterior lumbar interbody fusion?

Anterior lumbar interbody fusion (ALIF) is an advanced procedure often used when there is instability in the spine or shifting of a vertebrae from spondylolisthesis. It is a technique that is also used to when there is degenerative disc disease and stenosis in the lumbar spine. ALIF involves making an incision on the lower stomach and accessing the spine through the abdomen. The disc material is removed and a large stabilizing implant with bone graft is placed to fuse two vertebrae together. The benefits of an ALIF approach are the ability to place a larger implant, increase stability, and restore anatomic alignment.

Who is a good candidate for this procedure?

Potential candidates for ALIF are patients with instability in the lumbar spine from disc degeneration, spondylolisthesis (where one vertebra has slipped forward over another), degenerative scoliosis (spine misalignment), or recurrent herniated disc. If these conditions are causing nerve impingement or stenosis resulting in pain, numbness, weakness, or other neurologic dysfunction surgery may be necessary. However, not everyone is an appropriate candidate for this procedure. A surgeon who is trained in ALIF and other spinal fusion techniques is the best person to determine the most effective surgical option for each patient. A consultation with the proper surgeon is crucial in making that determination.

Anatomy

The lumbar spine, or low back, includes the five largest and strongest vertebrae. Between each vertebra is a gel-filled disc that acts like a shock absorber, providing a cushioning effect to absorb pressure and distribute stress. The lumbar spine is vulnerable to many pain-provoking disorders, ranging from simple strains to a herniated disc, degenerative disc disease, spondylolisthesis or spinal stenosis.

When is surgery recommended?

If you have worsening back or leg pain resulting from spondylolisthesis, disc degeneration, a recurrent herniated disc, or other spine abnormality that limits your everyday activities, and all non-surgical methods of treatment have failed, you should consider spinal fusion surgery.

The type of fusion surgery you have depends on many factors including your overall health, the location and severity of your problem, and your pain and disability. It is very important that you are carefully screened by a qualified surgeon who is trained in spinal fusion techniques to determine the most appropriate course of action.

What is the recovery time?

Patients are typically in the hospital for 2 to 3 days after an ALIF operation. Patients are walking the next day after surgery and have physical therapy while in the hospital to help with walking, mobility, and stair climbing. Some activities are restricted after surgery to allow for post-operative recovery. Typically, lifting is limited to 5 lbs for the first 2 weeks and 25 lbs for the following 4 weeks. Many patients who have ALIF surgery are able to return to normal activities in as little as six weeks. When to return to work will depend on the type of work you do, but typically ranges from 2 weeks to 6weeks post operatively. As with all surgical procedures, specific recovery time varies by patient and demand.

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