Anterior Lumbar Interbody Fusion

Anterior lumbar interbody fusion (ALIF) is a spine surgery that involves approaching the spine from the front (anterior) of the body to remove all or part of a herniated disc from in between two adjacent vertebrae (interbody) in the lower back (lumbar spine), then fusing, or joining together, the vertebrae on either side of the remaining disc space using bone graft or bone graft substitute.

The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together and stabilize the spine. Instrumentation, such as rods, screws, plates, cages, hooks and wire also may be used to create an “internal cast” to support the vertebral structure during the healing process.

Depending on your condition and your surgeon’s training, experience and preferred methodology, an ALIF may be done alone or in conjunction with another spinal fusion approach. Please discuss your fusion approach options thoroughly with your doctor, and rely on his or her judgment about which is most appropriate for your particular condition.

Symptoms

  • One or more fractured (broken) vertebrae
  • Spondylolisthesis (slippage of one vertebral bone over another)
  • Abnormal curvatures of the spine, such as scoliosis or kyphosis
  • Protruding or degenerated discs (the cartilaginous “cushions” between vertebrae)
  • Instability of the spine (abnormal or excessive motion between two or more vertebrae)

How does an Anterior Lumbar Interbody Fusion work?

For an ALIF procedure, the patient is positioned on his or her back and sedated under general anesthesia. The surgeon then:

Makes an incision in the abdomen and retracts the abdominal muscles, organs and vascular structures – including such major blood vessels as the aorta and vena cava – for a clear view of the front of the spine and access to the vertebrae. (This part of the procedure may be performed by a general surgeon or vascular specialist.)

Removes all or part of the degenerated disc(s) from the affected disc space, and inserts bone graft or bone graft substitute into the disc space between the vertebral bodies, to support the disc space and promote bone healing.

Returns the abdominal organs, blood vessels and muscles to their normal place, and closes the incision.

Surgeons typically perform an ALIF as a traditional, open procedure as described above; however, another option is to access the spine using minimally invasive (endoscopic) technologies that allow surgeons to reach the affected vertebrae through small incisions and intramuscular tunnels created to accommodate special guidance, illumination and surgical tools.