Introduction
Anterior lumbar interbody fusion or ALIF is a surgical procedure to fuse adjacent vertebral bones in the lumbar spine after removing the intervertebral disc. The aim of the procedure is to relieve pain and improve spinal stability.
Disease Overview
Nerves from the spinal cord pass through spaces between the vertebral bones to communicate with the rest of the body. Bony irregularities or degenerated intervertebral discs in the lower back or lumbar spine can compress the spinal cord and nerves leading to pain. This may be aggravated by movement of the adjacent vertebral joints.
Indications
Spine pain may be associated with age-related wear and tear, injury, overuse, abnormal spine curvature, infection or a tumor. The most common indications for ALIF include severe low back or leg pain that is unresponsive to non-surgical treatment, degenerative disc disorder, slippage of one vertebra on another or spondylolisthesis, fractures of the spine, tumors, and spinal instability.
Surgical procedure
Anterior lumbar interbody fusion surgery is usually performed under general anesthesia with the patient positioned supine, lying on the back. The surgeon makes an incision in the abdomen and retracts the muscles and various structures to enhance the clarity and accessibility to the anterior aspect of the vertebrae. The surgical approach is from the front of the vertebral body in the low back region.
Your surgeon removes the damaged disc or a part of the damaged disc between two adjacent vertebrae followed by fusion of the same with or without the use of bone grafts. External implant materials such as rods, screws, plates, and wires may be fixed to the treated vertebrae to provide extra support and stability during the healing process. At the end of the procedure, the structures are moved back and the skin is closed with sutures.
The success of surgery depends on various factors such as the patient’s age, spinal condition, overall health status, and activity level.
Post-operative Care
The recovery period after ALIF surgery varies depending on the body’s healing capacity. The post-surgical hospitalization includes a rehabilitation program. Your surgeon may prescribe pain medications or a brace and follow-up physical therapy upon discharge.
Your surgeon will instruct you on activity restrictions to follow depending on a few factors such as the type of surgical procedure and the approach used to access your spine, the size of the incision and presence of any complications.
Returning to work or normal activity depends on the type of work or activity you plan to perform. Usually 3 to 6 weeks is the ideal time for healing. With advanced and innovative surgical techniques, it is now possible to achieve improved fusion rates and a shorter hospital stay with an active and rapid recovery period.
Risks and complications
As with any surgical procedure, an anterior lumbar interbody fusion may be associated with certain risks such as infection, bleeding, and nerve damage. The underlying risk of any spinal fusion surgery is failure to fuse the vertebral bones and bone graft, which usually requires an additional surgery.
Summary
Anterior lumbar interbody fusion can relieve pain and stabilize the spine in the lower back. Approaching the spine through the abdomen has several advantages including a faster return to your normal activities.
