What is Anterior Lumbar Interbody Fusion?

Anterior lumbar interbody fusion (ALIF) is a type of spine surgery that fuses disc space through the abdomen instead of the lower back. Discs are the body’s natural shock absorbers. These structures sit between adjacent spinal bones (called vertebrae) and help make the spine flexible. When discs rupture or bulge, the material can tighten the space in the spinal canal and put pressure on the nerves. Fusing disc space means removing the disc that is causing the patient pain and replacing it with a new bone, implant, or combination of the two.

Although it was first performed in the 1950s, anterior lumbar interbody fusion did not become a standard procedure among spine surgeons until the 1990s. The introduction of threaded titanium cages played a significant role in universalizing this surgery. Titanium cages help hold the space between spinal discs together leading to improved fusion rates.

Advantages of Anterior Lumbar Interbody Fusion

Most spine surgeries occur at the back or side of the body. The ALIF is one of the few treatments where the incision is made at the front. Doctors often avoid making frontal incisions during spine surgery because so many vital organs are present. It was only recently that medical researchers discovered that frontal surgery can be done near the abdominals. A surgeon can push aside abdominals muscles to make room for his surgical tools without damaging the vitals. Large blood vessels that go down the whole body lay on top of the spine, so most spine doctors will operate in conjunction with a vascular surgeon who can adjust the vessels.

Because of the ALIFs unique positioning, the operation can be conducted without disturbing the back nerves and muscles. The spine compresses when the patient is lying on his back, which often leads to improved fusion due to spine compression. Larger implants that improve stability can be installed from the front as well. Now that threaded titanium cages come in various shapes and sizes developed for different body types, fusion rates for ALIFs are between 90 to 95%.

Should You Have Anterior Lumbar Interbody Fusion?

While the ALIF has many advantages, there are still inherent risks like any other surgery. You should speak with a medical expert who specializes in spine surgery and can consult you on the best option. Many spine surgeons will recommend conservative treatment before moving on towards surgery. For a diagnosis on what may be causing your back pain, contact the Spine Institute.