ALIF
Anterior lumbar interbody fusion (ALIF) is one of the most frequently used spinal fusion techniques and is performed through the front of the body (anterior approach) through the abdomen. Interbody fusion refers to the removal of an intervertebral disc, which is replaced with a spacer during the fusion process. A major advantage of anterior entry is that a larger implant can be incorporated into the procedure.
An ALIF procedure is performed to treat deformity of the spine, nerve compression, and associated pain. Such compression of spinal nerves may occur as a result of progressive disc degeneration, slippage of the vertebrae (spondylolisthesis), abnormal curvature of the spine (scoliosis, kyphosis, or loss of lordosis), or other causes of progressive spinal instability. The ALIF procedure is typically used to fuse either the lowest level of the spine (L5/S1), the second-lowest level of the spine (L4/5), or both.
Patients with persistent low back pain, which often radiates down the leg, may be candidates for ALIF if more conservative treatments, such as rest, non-steroidal anti-inflammatories (NSAIDs), physical therapy, and corticosteroid injections, have not been effective in relieving their symptoms.
Procedure
ALIF is performed under general anesthesia, with the patient lying face-up. Dr. Radcliff makes a small incision in the lower abdomen, through which the damaged disc is removed.
A cage (or spacer) is then inserted in the disc space. The cage is typically made of either titanium or medical-grade plastic and packed with bone graft. After inserting the cage, Dr. Radcliff will place either a metal plate or screws and rods in the vertebrae to maintain the stability of the spine around the cage as the vertebrae grow together and fuse.
As the bone grows and heals itself, it binds (fuses) the two vertebrae together into one solid bone. The goal is to stabilize the spine, reduce pain, and correct deformity.
Recovery
The recovery period for a spinal fusion procedure such as ALIF will vary depending on your body’s ability to heal and firmly fuse the vertebrae together. Patients typically stay in the hospital overnight. Sometimes, a longer length of stay is required if the ALIF is performed as part of a multi-stage procedure. A physical therapy regimen is started soon after to assist the patient in regaining strength and mobility. Certain activities may be restricted, including lifting, twisting the midsection, and bending at the waist. Many patients with non-physical jobs return to work within a few weeks. However, heavy lifting and manual labor are typically prohibited for a period of time.