Anterior Lumbar Interbody Fusion (ALIF) is a type of lumbar (lower back) spine surgery.  The procedure involves approaching the lumbar spine from the front (anterior) of the patient's body, removing a disc, and implanting one or more interbody devices (such as cages) packed with bone graft. 

ALIF Procedure

An incision is made in the patient's abdomen, and the abdominal contents are gently moved aside to gain access to the front of the spine. Sometimes, this part of the surgery is performed by a vascular or general surgeon who is more familiar with abdominal anatomy.

The spine surgeon separates the muscle fibers instead of cutting through them. A discectomy is performed, and one or two interbody devices (such as cages) are filled with bone graft and implanted in the empty disc space.  More bone graft is packed around the interbody device.

A metal plate may be placed over the interbody device and bone graft to provide spinal stability.  The plate is affixed to the vertebral bodies using special screws.  Further, the plate holds the bone graft in place.  ALIF is often combined with posterior fusion (performed from the back of the spine) using pedicle screws.  Posterior fusion provides additional spinal support and stability.

Potential Benefits

• ALIF may be performed as a mini-open procedure.  This minimally invasive spine surgery preserves the abdominal muscles by separating muscle fibers instead of cutting them.
• ALIF does not disturb posterior (back)  muscles and nerves.
• ALIF does not require removing spinal bone to access the disc or vertebra.

Possible Risks and Complications

• ALIF may be difficult to perform on obese patients.
• At the L4-L5 level, two major arteries and veins branch into the legs. If nicked, serious bleeding can occur.  Bleeding complications can lead to loss of leg function.  If the ALIF involves L4-L5, this possible complication should be considered.
• If the patient had prior abdominal surgery, scarring and adhesions may make this procedure more difficult.

We Can Help You Make Informed Decisions

Spine surgery is an important decision.  While the final decision is yours, the benefits, potential risks and complications require careful consideration.  We look forward to answering your questions and helping you to resolve your concerns about any treatment offered by Piedmont Spine Center.