Anterior Lumbar Interbody Fusion
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What is it?
Anterior Lumbar Interbody Fusion (ALIF) is a surgery that is performed when fusion of the lumbar spine (lower spine) is required. This could be for a variety of reasons. Often, your surgeon may work in conjunction with another surgeon specializing in vascular or general surgery to assist with the initial aspects of the surgery, as it involves making an incision in the belly and proceeding to the spinal column from the front (anteriorly).
What is its goal?
ALIFs are done to achieve fusion of the lumbar spine. With many degenerative or traumatic diseases of the spinal column, fusion is required to maintain the alignment or prevent further disease. This can be accomplished in a variety of ways but the end goal is to cause fusion of the spinal column at the segments in question
How is it done?
Your surgeon will describe to you in specific detail how he or she performs the surgery. In most cases, general anesthesia is required. You will be on your back for the surgery. A general surgeon or vascular surgeon may assist in the beginning of the procedure to expose the necessary anatomy and protect important structures (like the aorta) near the operative site. Your surgeon will then remove any abnormal bone and disc material and place a box between the vertebral bodies. He or she will then place screws in the bodies and connect them with rods or plates. Compounds to aid with bony fusion may be used if deemed necessary. The overlying tissue and skin are then closed with sutures and the anesthesia team will reverse the anesthesia and remove the breathing tube as you wake up.
What are the risks?
In addition to the standard surgical and anesthestic related risks of bleeding, infection, stroke, coma, heart attack, and death, the specific risks to an ALIF are blood vessel damage, bowel injury, nerve damage and the need for further surgery. Most people do very well following an ALIF with complication rates in the medical literature ranging from 1 – 15%.
What is the success rate?
In experienced hands, the fusion rate can be as high as 90+%. This, however, depends on a variety of factors, depending on the level of surgery, and your specific situation. Talk to your surgeon about the specific variables that can affect your fusion rate.
How long will I stay in the hospital?
Most people will stay in the hospital between 2 – 4 days after their surgery. Various factors, such as mobility, pain control and physical therapy requirements can affect length of stay.