Anterior lumbar interbody fusion (ALIF) is a spinal surgery that involves removal of all or part of a disc from in between two contiguous vertebrae (interbody) from the front of the vertebral body in the lower back region (lumbar spine) and fusing or joining the two vertebrae together so that they heal into a single, solid bone. A bone graft or a substitute bone graft can be used on both sides of the remaining disc space of the vertebrae. 

The graft material binds the two vertebrae together and promotes bone healing, facilitates the fusion and helps to preserve the normal disc height as the body heals. Along with the vertebral bone, the bone graft also grows and stabilizes the spine.

Your condition and your surgeon’s experience, training or preferred methodology may determine the performance of ALIF surgery alone or in combination with another spinal fusion approach. Discuss the options of surgical approach thoroughly with Dr. Blankenship.

What are the conditions that can be treated by (ALIF) surgery?

The recommendation of spinal fusion by a surgeon depends on various reasons and the procedure is most commonly used to treat conditions such as one or more fractured vertebra, spondylolisthesis or slippage of one vertebra over another, presence of abnormal curvatures of the spine such as scoliosis or kyphosis, any protrusion or degeneration of the disc (the cartilaginous structure that ‘cushions’ between vertebrae) and instability of the spine or excessive motion between two or more vertebrae.

What is the procedure of the ALIF surgery?

The ALIF surgery is usually performed under general anesthesia and the patient is positioned lying on their back. Dr. Mullis (the exposure general surgeon) makes an incision in the abdomen and retracts abdominal muscles, organs and other vascular structures including major blood vessels such as aorta and vena cava to get a clear view of the front of the spine and accessibility to the vertebrae. Dr. Blankenship removes the whole or a portion of the degenerated disc from the affected disc space and inserts the Enza-A implant into the disc space. Dr. Blankenship was the lead design surgeon for the Enza-A implant. Dr. Blankenship and Dr. Mullis have performed several thousand ALIFs over three decades and over 700 implantation of the Enza-A implant.

Patients generally go home the following day. The post-surgical hospitalization also includes the rehabilitation program.

Post operative physical therapy usually starts the following week after surgery. Another consideration for returning back to work or normal activity depends on the type of work or activity you plan to perform. Usually 3 to 6 weeks of healing time is needed. Within the last few years many innovations and advancements have been developed that help to improve fusion rates, reduce hospital stays and deliver more active and rapid recovery periods.

Who are candidates for (ALIF) surgery?

Patients with certain symptoms such as low back or leg pain due to degeneration of disc, spondylolysis or spondylolisthesis, scoliosis or any spinal instability that have not responded to other non-surgical treatment measures such as rest, physical therapy or medications may be appropriate candidates for an ALIF surgery.

Before offering the ALIF surgery, Dr. Blankenship considers various factors such as the condition to be treated, your age, health, lifestyle and your expected level of activity after the surgery.