Overview and Indications
Anterior lumbar interbody fusion (ALIF) is a type of spinal fusion that utilizes an anterior approach to fuse the lumbar spine bones together. Interbody fusion means the intervertebral disc is removed and replaced with a bone or metal spacer using an anterior approach in this case. The anterior technique is often favored when multiple spinal levels are being fused and multiple discs need to be removed. ALIF may be performed in conjunction with or without a posterior decompression (laminectomy) and/or use of metal screws and rods. The anterior ALIF approach is also ideal when only one spinal level is fused and a posterior decompression and/or instrumentation are not required. Although the anterior lumbar ALIF approach involves temporarily moving out of the way large blood vessel and the intestines, there is a wide exposure of the intervertebral disc without retraction of the spinal nerves and neurologic structures and therefore, a decreased risk of neurologic injury.
ALIF is commonly performed for a variety of painful spinal conditions, such as spondylolisthesis and degenerative disc disease, among others.
Most patients are usually able to go home three to four days after surgery. Patients will typically stay longer, approximately four to seven days, if a posterior spinal surgery is also performed. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending at the waist, lifting more than five pounds and twisting in the early postoperative period (first two to four weeks) to avoid a strain injury. Patients can gradually begin to bend, twist and lift after four to six weeks as the pain subsides and the back muscles get stronger.
Patients may be issued a soft or rigid lumbar corset that can provide additional lumbar support in the postoperative period, if necessary.