In these cases, additional surgery may be needed. Often, your surgeon may work in conjunction with another surgeon specializing in vascular or general surgery to assist with the initial aspects of the surgery, as it involves making an incision in the belly and proceeding to the spinal column from the front (anteriorly). Yagi M, Hosogane N, Fujita N, Okada E, Suzuki S, Tsuji O, Nagoshi N, Nakamura M, Matsumoto M, Watanabe K. Sci Rep. 2020 Jun 9;10(1):9341. doi: 10.1038/s41598-020-66353-7. During spinal fusion, your surgeon places bone or a bonelike material within the space between two spinal vertebrae. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: This is a preliminary report of ALIF operations at our center, the Oswestry Disability Score is collected before the operation and then compared with post operative status at six weeks, three months and six months and these are not yet all complete for all 20 cases. A particular risk to be aware of is retrograde ejaculation. So if you have been limited with back problems for 6 months, it may take that long to get back to all of your usual activities. The pictures show acceptable reduction of slip and solid fusion 6 months later. Also contraindicated are cases of highly collapsed disc space, as there is a chance of auto fusion between both levels. Fleischer GD, Hart D, Ferrara LA, Freeman AL, Avidano EE. Receive health news and wellness tips. doi: 10.5435/JAAOSGlobal-D-18-00067. Schnake KJ, Rappert D, Storzer B, Schreyer S, Hilber F, Mehren C. Orthopade. {"@context":"","@type":"FAQPage","mainEntity":[{"@type":"Question","name":"What is Anterior Lumbar Interbody Fusion (ALIF) Surgery","acceptedAnswer":{"@type":"Answer","text":"Anterior Lumbar Interbody Fusion (ALIF) Surgery\nAnterior Lumbar Interbody Fusion (ALIF) Procedure\nAn anterior lumbar interbody fusion (ALIF) is performed to remove a large portion of a degenerated disc that is causing back pain. hޤR[k�0�+z�2]| C�6]`iCm�Bȃ�h��/�V���;G��d��"d��;7�cˆ�w�C\��%a�9=rqA㺨�d/3�F�c8#wQD���u��F�:������KS�i�WsZx��Y��./g4UϚ�K�U�>�>�V��KND`�hE�q��k��.�/Y� The patients included in this study had an indication for spinal fusion and/or spinal decompression. The position of the ALIF cage is checked within the space by a lateral and anteroposterior (AP) fluoroscope again to make sure the posterior border of the cage is just a millimeter in front of the posterior border of the vertebrae. Demographic and clinical data is shown in Table 1. Click the links below to learn more about the selected treatment: Anterior Lumbar Interbody Fusion (ALIF) is an operation to stabilize the spine, relieve pressure on irritated nerves and ensure this pressure does not return.

The intraoperative complications that come from open surgery, such as the dura tear, do not exist. The incidence of retrograde ejaculation is not high, but it can be a serious problem in younger men who plan to have children. This may result in considerable weakening of the spinal muscles due to lack of exercise, so you should return to normal activities slowly over several weeks. Infections may be superficial or deep into the bone. However, there are some disadvantages with this method. The reflected arcuate line is cut longitudinally to enter the retroperitoneal space. Clinical and Radiologic Fate of the Lumbosacral Junction After Anterior Lumbar Interbody Fusion Versus Axial Lumbar Interbody Fusion at the Bottom of a Long Construct in CMIS Treatment of Adult Spinal Deformity. This is because of a tendency of failure in the elevation of the disc space height before the insertion of the cage. The ability to open the disc space height and to reduce the slippage of vertebrae using a big cage is appropriate for spinal stenosis from neural foramina narrowing from collapsing or bulging discs in spondylolisthesis grade 1 and 2 (both degenerative or lytic in origin). The advantages of the possibility of achieving solid fusion in ALIF means there is a lower likelihood of back pain remaining from pseudarthrosis, which is generally more prevalent in posterior spinal fusion surgery.

There is a risk of massive bleeding from even a small leakage of the great vessel, especially from the venous structure that is easily torn. These show very satisfactory results with rapid improvement of physical function after surgery. ALIF is my preferred technique for accessing the L5-S1 intervertebral level. However, when only cases in which bilateral pedicle screws supported the interbody fusion, no statistical difference (P>0.05) between the 3 techniques was identified. Get the latest research from NIH:

Spondylolisthesis grade 1 and 2 (degenerative / Lytic).  |  In most cases, general anesthesia is required. The technical team must be prepared for any inadvertent condition arising during surgery.

Coronavirus (COVID-19) Updates: Visitation Policies (New! Ajiboye RM, Alas H, Mosich GM, Sharma A, Pourtaheri S. Clin Spine Surg. h�bbd``b`�@���]$��@D�x����Ȱ���7�q�/� �� This may be accomplished by activity restriction, the wearing of a soft support brace, or a hard plastic brace. In a paired analysis directly comparing fusion techniques, only the difference between a TLIF and an axial interbody fusion was significant.

One of the advantages of ALIF surgery is the factor of disc space correction, the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance when compared to open posterior instrumentation.18 In our study we showed positive improvements in disc height in all cases after surgery. Injury to the superior hypogastric plexus (which lies beneath the peritoneum, courses to the aorta (anterior view) and crosses anterior to the left common iliac vein) can cause retrograde ejaculation. The rate of surgical success varies greatly depending on your exact problem, overall health, and the magnitude of surgery necessary. Some patients had only one symptom, either back or leg pain. 36 0 obj <>stream This surgery typically involves an incision in the left lower quadrant of your abdomen, but depending on the number of levels being fused, other incisions may be employed. We track our outcomes after surgery and have experienced a very high success rate. The surgery to widen the space for nerves from the posterior might not be enough. This is the key to success in solving spinal instability that can cause chronic back pain.1 With this well-designed intervertebral cage in full anteriorposterior diameter, there is also the strongest likelihood of opening the intervertebral foramen and neural canal that has collapsed due to spondylolisthesis or degenerative disc disease. It is necessary to increase the height of the disc, which results in an indirect decompression and becomes a highly successful fusion, which is based on kinetics as well. Epub 2015 Jun 12. Anterior lumbar interbody fusion is just one of the many surgeries our neurosurgeons perform to treat back pain.

This is because this surgery can take the pain generator (i.e. The clinical outcomes show rapid and long lasting improvement in back pain, leg pain and quality of life. As a rule of thumb, for a healthy adult it takes about as long to get back in shape as you have been sick. In general, we recommend two to three episodes of exercise per day. The mean ODI pre-operative visit was 41.9 (±28.2) and this reduced to 13.8 (±14.3) at the six-week visit and continued to reduce to 4.3 (±6.5) at the three-month visit and 0.35 (±1.0) at the six-month visit (Figure 9). However, there are some disadvantages of this method. The correctly sized Synfix® cage is then opened from its container and filled with the bone graft substitute (bone morphogenetic protein (BMP) or demineralized bone matrix graft (DBM)) and inserted into the selected disc space.

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Radiographic and Clinical Outcomes of Anterior and Transforaminal Lumbar Interbody Fusions: A Systematic Review and Meta-analysis of Comparative Studies. 2013 Dec 15;38(26):2264-71. doi: 10.1097/BRS.0000000000000045. “I had developed left leg and lower back pain. Some may need anterior vertebral column support and fusion anteriorly. S. … Along with reports of shorter surgery times and lower blood loss, this substantiates the safety of ALIF procedures in a subset of the general DDD population. Any male patients who wish to undergo this surgery receive counseling about the risk of retrograde ejaculation that can lead to infertility. The surgeon should be familiar with the possibility of anatomical variation of all blood vessels in order to get an adequate exposure. The advantage of stand-alone anterior fusion is to avoid complications of posterior fusion disease.2 The modern anterior inter-body cage device was designed to have a bigger and larger area able to carry the human body weight, and placed around the area of the apophyseal ring of the vertebral end plate which is the strongest bone with the least likelihood of implant subsidence.

2018 Aug;8(5):512-516. doi: 10.1177/2192568218756908. Failure of fusion: On rare occasions the bone graft does not heal properly. Depending on how long the symptoms have been present, strength is usually the second symptom to improve.

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