Anterior lumbar interbody fusion (ALIF)surgery also is used to remove a portion of bone and disc from the spine to replace it with an implant that is inserted into the disc space. During ALIF, the disc space is fused by approaching the spine through the abdomen instead of through the lower back, as in the TLIF procedure.The goal of the procedure is to obtain a solid fusion between two vertebra, and if this is not achieved, further surgery may be required.
During ALIF surgery, Dr. Siddiqi will make a three-to-five inch incision on the left side of your abdomen and retract the abdominal muscles to the side. In some cases, he may be able to use an endoscope, which involves making several one-inch incisions to reach the abdominal muscles.
In many cases, ALIF is combined with a posterior approach, such as TLIF, but if little instability exists in the disc space, an ALIF alone can be sufficient. Dr. Siddiqi will perform a diagnostic evaluation to determine if spinal fusion surgery is recommended for your condition.
ALIF and bone grafts
ALIF surgery is performed by placing bone grafts around the spine to cause two vertebral bodies to grow together into one long bone. The bone for the graft may be taken either from another bone in the patient – usually the hip (autograft) - or from a bone bank (allograft). Additionally, spinal fusion may involve the use of plates, screws and cages.
During the ALIF approach, both the back muscles and nerves remain undisturbed, which can be considered a definite advantage over posterior approaches. Also, by placing the bone graft in the front of the spine, compression is created that tends to increase the likelihood of bones becoming fused together.
ALIF surgery potential risks and complications
Because the ALIF procedure is performed in close proximity to the large blood vessels that go to the legs, there is a risk (one to 15 percent) that damage to these large blood vessels may result in excessive blood loss. Males also run the risk of the procedure creating a condition known as retrograde ejaculation, which is caused by approaching the disc space from the front. Other risks of spinal fusion surgery include infection and bleeding. Dr. Siddiqi will discuss all risks and benefits to ALIF with you before scheduling the procedure.
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