What is an Anterior Lumbar Interbody Fusion (ALIF) surgery?An anterior lumbar interbody fusion (ALIF) surgery is one of the different methods of spinal fusion surgery. This technique requires the surgeon to make an incision in the front (abdominal region) in order to access the spinal column. This anterior (frontal) approach is preferred when the surgery involves fusing multiples vertebras or removing multiple vertebral discs. This surgery may be performed in combination with or without a laminectomy (posterior decompression) using metal rods and screws.
What is the procedure for using Anterior Lumbar Interbody Fusion (ALIF) technique?The surgery begins with administration of general anesthesia to the patient. Patient is positioned in their back and the procedure starts with the surgeon making a small incision in the abdominal region above the lumbar vertebras that need treatment. The surgeon will spread the abdominal muscles and move aside the larger blood vessels and the intestines to gain clear access to the spinal column. The surgeon will use specialized instruments to remove the damaged vertebral discs and other set of instruments to restore the normal height between the vertebras in order to place the spacer (bone graft or metal/plastic implant) between the vertebras. After having confirmed that the ‘spacer’ is accurately in position the surgeon will then wash the area with sterile antibiotic solution. The intestines and large blood vessels are then moved back into their original position which is followed by suturing the subcutaneous layer and the skin together. It takes around 2-3 hours normally for an ALIF surgery but depends on the number of spinal levels needing treatment.
What are the Anterior Lumbar Interbody Fusion (ALIF) success rates and risks?The success rate of an anterior lumbar interbody fusion (ALIF) surgery can be as high as 90% and more if done by a highly experienced surgeon. However, the actual rate of success depends upon various factors such as your individual situation as well as the level of surgery. Your surgeon will be able to inform you regarding the chances of a successful ALIF procedure in your particular case. The most common risk in an ALIF procedure is the damage that may be caused to the number of large blood vessels that may result in excessive blood loss. This risk can be avoided to a large extent if the ALIF procedure is performed by an experienced surgeon. Males are at risk of a condition called as ‘retrograde ejaculation’ if ALIF is performed for lumbar segment 5 and sacral segment 1. The reason for this is the presence of small nerves, responsible for expelling ejaculation during intercourse, which are in close proximity of these discs. Damage to these small nerves can affect ejaculation quality in a person. Other risks that may be related to an ALIF procedure are the non-union of the vertebras in around 5% of cases. This is especially a concern for patients who have undergone lower back surgery previously, smoke or are obese, have had multiple level fusion surgery and have been treated with radiation for any type of cancer. The other uncommon types if risks are the chances of bleeding or infection which are very rare nowadays with the use of pre-operative antibiotics and anti-coagulants (blood thinners).