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As the other methods of non-surgical treatment become exhausted, you can opt for anterior lumbar interbody fusion as a solution for pain relief. Our spine specialists at Cedars-Sinai Marina del Rey Hospital always make the best decisions concerning your health, thanks to their extensive experience and training.
Using state-of-the-art technology and techniques, the nation’s leading spine surgeons will make sure the ALIF procedure will be the defining step in your rehabilitation.
ALIF (anterior lumbar interbody fusion) resembles PLIF (posterior lumbar interbody fusion). However, there is a difference; in ALIF, in order to achieve disc space fusion, the spine is approached through the abdomen and not through the lower back like in PLIF.
An anterior approach might not suffice to achieve a more rigid fixation. In this case, ALIF and a posterior approach can be conjointly deployed.
Yet, if there is sufficient stability, ALIF alone can suffice. This often happens when patients suffer from one level degenerative disc disease which implies great disc space collapse.
The following series of steps are performed to complete an ALIF procedure:
The spacers inserted in ALIF are typically twice as big as the spacers used in TLIF or PLIF, both of which are performed from the patient's back side. The larger spacers:
The spine can also be reached through the abdomen by using a transperitoneal approach. However, this technique would add a lot of morbidity to the operation and this is why surgeons don’t use it very often. Doctors often perform this surgery together with a vascular surgeon who can mobilize the large blood vessels (aorta and vena cava) which lay atop of the spine and continue to the legs. The surgeon removes the disc material once the blood vessels are pulled aside. Then, the bone graft or the graft and the anterior interbody cage can be inserted.
ALIF surgery has the following advantages:
ALIF is performed in the area where the large blood vessels which go to the legs are located. This poses significant risks because if these vessels are affected, the patient may suffer excessive blood loss. Statistically, the risk rates are 1 to 15%. Nonetheless, an experienced surgeon will know how to avoid this risk.
Male patients who undergo ALIF are exposed to an additional risk; the intervention can lead to retrograde ejaculation if L5-S1 disc space is approached frontally. This doesn’t cause impotence because the nerves from that area don’t play a part in the erection. Moreover, statistics point out that retrograde ejaculation is registered in less than 1% of interventions and it heals within the next months.
Have you had consistent pain, particularly the kind that is associated with a worn or degenerated disc in the lower part of your back? Have you tried non-invasive treatments without success? You may be a candidate for back surgery to relieve your symptoms for the long term. Call us at 888.600.5600 to find out more and schedule a consultation today!
Here is an example of a patient who underwent an ALIF procedure with pedicle screw placement. The patient suffered from back and bilateral leg pain for two years. His condition was not improved although he tried oral medication, therapy, spinal injection, as well as adapting his activities. He then decided to go through ALIF; the procedure deployed a PEEK spacer, decompression, and posterior pedicle screws. The patient’s pain was reduced from 9 out of 10 pre-op to 3 out of 10 post-op (he had the last follow-up after 18 months).
This is an example of ALIF performed with an anterior plate. The advantage of using an anterior plate is that the surgeon can rely on the muscle-sparing anterior approach (frontal), without disrupting the posterior back muscles. The patient felt back pain and pain in his left leg. He had gone through an intensive program of physical exercises for trunk stabilization and he had taken spinal injections as well. He then tried to find a solution for his stenosis and degenerative disc disease by opting for fusion at L5-S1 via ALIF, decompression, and pedicle screws. After this treatment option, his pain diminished from 8/10 to 3/10 and his last follow-up examination was two years after the intervention.
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