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Anterior Lumbar Interbody Fusion (ALIF)

What is Anterior Lumbar Interbody Fusion?

Anterior Lumbar Interbody Fusion, or ALIF, is a fusion procedure where the spine is accessed through the patient’s abdomen.

Anterior lumbar interbody fusion (ALIF) is a type of spinal fusion which involves an anterior approach to fuse lumbar spine vertebrae (bones) together. Anterior refers to the front of the body. Lumbar means the last five vertebrae of the spinal column. Interbody refers to the disc space between the vertebrae to maintain and reestablish disc height. Interbody spacers may have material inserted inside them to help promote fusion. Fusion means to surgically induce a union or joining of bone.

ALIF is usually performed to treat a variety of painful spinal disorders, including painful conditions like Degenerative Disc Disease and Spondylolisthesis. ALIF is preferred when there is a need to fuse multiple spinal levels and remove multiple discs. Frequently a vascular surgeon is used to help provide  the exposure of the surgical site.

General Anesthesia

Patients are given a general anesthesia and preoperative intravenous antibiotics. They are then laid on their backs on a radiolucent operating table. A 3-to 8-centimeter incision is made in the abdomen and the  abdominal muscles and intestines are moved aside.

The damaged intervertebral disc is removed by the neurosurgeon.

Restore Height

Special distractor instruments are used to restore the normal height of the disc space and to determine the appropriate size of bone graft. A cage filled with bone graft is carefully implanted in the empty disc space. This helps to realign the vertebrae and remove the pressure from pinched nerve roots. Fluoroscopic X-rays are taken to confirm the graft is in the right place.

Secure the Vertebrae

If additional support is required for the spine, surgeons may decide to attach a plate to the spine for support during the healing process. This will connect the above and below vertebrae.  The surgeon may decide to perform the surgery in two stages. The second stabilization procedure is usually performed two days later from the back part of the spine with rods and screws

Ending the Procedure

Over time, the bone graft will grow through and around the implant.  The wound area is washed out with sterile antibiotics. The procedure ends when the skin is sewn or glued together.

What happens after the procedure?

Most of the patients are allowed to go home after 3 to 4 days of surgery. Before patients can go home, they are instructed by physical therapists.

They are given proper instruction about:

  • The right techniques to get in and out of the bed
  • The techniques to walk independently
  • The need to avoid bending at the waist
  • The need to avoid lifting weight more than 5 pounds

The patients are allowed to resume bending, twisting and to lifting about 12 weeks after surgery.

  • The following complications may arise after the surgery:
  • The graft may be displaced from its right position
  • The above and below vertebrae may not fuse together correctly
  • The wound may get infected by microbes
  • Vessels may be injured resulting in impaired lower extremity circulation or blood clots in the legs

This material is intended to give the patient an overview of surgical procedures and treatments and is not intended to replace the advice and guidance of a physician. Always consult with your doctor about the particular risks and benefits of your treatment.

Our Physicians

All neurosurgeons in our practice perform ALIF surgery.

Jonathan D. Chilton, MD FAANS
Geoffery L. Blatt, MD FAANS
William S. Rosenberg, MD FAANS
Peter Basta, MD FAANS
Jayson A. Neil, MD FAANS
Samuel Taylon, MD
Frances Hardaway, MD
Matthew J. Pierson, MD

Request an Appointment

Please call our office at 816-363-2500 to request an appointment.

If you have had any studies, such as MRI scans, CAT scans, arteriograms, electromyograms (EMG), or plain x-rays, please bring them with you to your appointment.

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