ANTERIOR LUMBAR INTERBODY FUSION (ALIF)
A diseased disc can be replaced with a bone spacer or implant to obtain a lumbar fusion. A specialized surgical approach through a frontal abdominal incision (3cm or more) is performed to expose the anterior spine. A vascular surgeon will perform the exposure with gentle dissection and retraction of the blood vessels in the front of the spine.
A spine surgeon trained in the anterior surgery then excises the disease disc and prepares the vertebral end plates for fusion. The diseased disc is then replaced with a spacer (bone wedge, metallic spacer, cage or other synthetic material). Bone graft is added to the spacer to initiate bone growth usually achieving fusion within 3 months. Back brace is usually recommended, and the patient is restricted from bending or twisting and only light lifting. Physical therapy usually is initiated at 3 months. Return to normal function and activity within 3-6 months.
A position lumbar laminectomy or decompression relieves pressure on spinal nerves by removing a portion of the rooftop of the vertebral body.
An incision is made in the midline of the lower back, approximately 3 cm or more in length depending on the number of levels. Disc degeneration, arthritis (bone spurs) or thickened ligaments can cause compression of the spinal nerves. Portions of the lamina and the bone spurs are removed with spinal instruments with the use of microscope.
Patients leave the hospital 1-2 days after surgery. In one to two weeks, the incisional pain is gone. Patients can experience improvement with walking, ability and reduction of leg numbness or weakness by six to eight weeks.