What is ALIF?
Spine surgery is a common option for patients with low back pain. A surgeon performs anterior lumbar interbody fusion (ALIF) to treat conditions such as degenerative disc disease, spinal stenosis, and fractured vertebrae before fusion. The term “fusion” describes the process in which two or more bones are joined (grafted) together. During ALIF surgery, bone graft is used to replace a degenerative or herniated cervical disc.
The anterior lumbar interbody fusion procedure opens the abdomen to remove a partially or totally herniated disc in the space between the low back’s adjacent vertebrae. A bone graft is then used to fuse the vertebrae in the disc space.
Eventually, the backbone and bone graft grow together and support the spine. Additionally, the graft material aids in achieving normal disc height by serving as a binding medium. Instruments such as rods and plates may maintain the backbone structure while it heals.
ALIF alone is best for patients who have little to no nerve compression and do not have excessive spinal instability or slippage. Conditions for back pain and instability in the legs such as spondylolisthesis and degenerative disc disease may require ALIF surgery.
- Spondylolisthesis results from one vertebra sliding forward over the one below it. A stress fracture in the bone that supports the vertebral body may cause the vertebra to move forward. This condition can cause low back and leg pain due to spinal nerve compression.
- Disc degenerative disease develops when discs change shape and size. These changes can lead to disc flattening (losing height), swelling, or herniating (rupturing) onto vulnerable nerve roots.
- Spinal stenosis is when the spinal canal and nerve root canals narrow. Enlarged facet joints and ligaments cause leg pain and numbness.
- Scoliosis occurs whenever the spine curves abnormally due to misalignment of the bones. This can occur in adults because of aging discs, arthritis, or previous spine surgery.
General anesthesia is administered to the patient prior to the ALIF procedure. The surgeon or a vascular specialist makes an incision in the abdomen to view the front of the spine and access the vertebrae. During this procedure, the surgeon retracts the abdominal muscles and organs. These include the aorta and vena cava. There is a complete or partial removal of the degenerative disc from the afflicted disc space.
The disc space is restored with the help of special distractor instruments, which determine the size of the bone graft. A bone graft is then placed in the disc space between the vertebrae to maintain it and promote bone healing.
An implanted plate can provide stability to the spine while the patient heals if the spine needs further support. This connects the vertebrae above and below. It is possible for the surgeon to divide the procedure into two phases. Rods and screws are usually used on the back of the spine in the second part of the stabilization phase two days later.
The implant will gradually expand around and through the bone transplant. The area around the wound is cleaned with sterile antibiotics. A stitch or adhesive is used to stitch together the skin.
Recovery time for a spinal fusion procedure such as an ALIF will vary based on the operation and your body’s ability to heal and fuse the vertebrae together. Unlike a spinal fusion, an ALIF does not interfere with the back’s muscles or nerves. In most cases, patients stay in the hospital for a few days, perhaps even longer for more complicated procedures.
There may also be a need to spend time in a rehabilitation facility. If necessary, your doctor may also recommend a brace, additional physical therapy, and pain medication. Physical therapy may include a review of how to get into and out of bed, walk independently, and avoid bending at the waist.
The type of treatment you receive, how your doctor approaches your spine, and whether you have suffered any serious tissue damage or problems may all affect how long you will be out of work. Another factor to consider is the type of work you intend to return to. The duration of a medical leave of absence typically ranges from three to six weeks. Advancements and improvements have led to faster recovery times and shorter hospitalizations.
Anterior Lumber Interbody Fusion May Be Best For You
In anterior lumbar fusion, there is no cutting of the back muscles, and the procedure is relatively short. The outcome and recovery of each patient vary depending on their health and lifestyle. Ensure that you follow all directions from your physical therapist and maintain a positive attitude. If you believe you are a candidate for ALIF surgery and want to speak to an experience spinal surgeon, schedule an appointment with Dr. Butler.