Anterior Lumbar Interbody Fusion (ALIF) in Roseville, CA

Anterior lumbar interbody fusion (ALIF) is a surgical procedure performed through the front of the body (anterior approach) and is typically used to fuse either the lowest level of the spine (L5/S1), the second lowest level of the spine (L4/5), or both. Spinal fusion procedures are performed for the relief of pain radiating from the lower back into the buttocks or legs. Currently one of the most frequently used spinal fusion techniques, ALIF is performed from the anterior of the spine through the abdomen. Interbody fusion refers to the removal of an intervertebral disc, which is replaced with a spacer during the fusion process. A major advantage of anterior entry is that a larger implant can be incorporated into the procedure.

Reasons for ALIF

ALIF is performed to treat deformity of the spine, nerve compression, and associated pain. Such compression of spinal nerves may occur as a result of progressive disc degeneration, slippage of the vertebrae (spondylolisthesis), abnormal curvature of the spine (scoliosis, kyphosis, or loss of lordosis), or other causes of progressive spinal instability.

Patients with persistent low back pain, which often radiates down the leg, may be candidates for ALIF if more conservative treatments, such as rest, non-steroidal anti-inflammatories (NSAIDs), physical therapy and corticosteroid injections, have not been effective in relieving their symptoms.

The ALIF Procedure

The ALIF procedure is performed under general anesthesia with the patient lying face up on an operating table. The surgeon makes an incision on the side of the abdomen near the affected area. The muscles of the back and the nerves do not need to be moved for this approach. The injured disc and other debris are removed.

A cage (or spacer) is then inserted in the disc space. The cage is typically made of either titanium or plastic, and packed with bone graft. After insertion of the cage, either a metal plate or screws and rods are inserted in the vertebrae to maintain stability of the spine around the cage. The spinal instrumentation secure the vertebrae in place, maintaining spinal stability as the vertebrae grow together and fuse.

Recovery From ALIF

After undergoing an ALIF procedure, patients typically remain in the hospital overnight. Sometimes, a longer length of stay is required if the ALIF is performed as part of a multi-stage procedure. A physical therapy regimen is started soon after to assist the patient in regaining strength and mobility. Certain activities may be restricted, including lifting, twisting the midsection, and bending at the waist. Many patients can return to work within a few weeks after the procedure if their employment does not require strenuous exertion. However, heavy lifting and manual labor are prohibited for 3-6 months after the procedure, depending on the extent of the surgery.

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