How An ALIF Can Give You Your Life Back

Lower back pain can keep you from doing the things you love. Every movement can be a painful reminder that something isn’t right in your back. It goes without saying, but you want to feel better as soon as possible. 

Have you tried more conservative approaches to treat your lower back pain with little or no success? It certainly can be frustrating. While you may be a little worried about choosing surgery, sometimes it is the best option.

An anterior lumbar interbody fusion (ALIF) helps to treat disc problems in the lower back. But how? Let’s take a closer look at your spine.

Understanding Your Lower Back Spine

The lumbar spine is the portion of your spinal column located in the lower back. This is the area where the spine curves inward toward the abdomen. It often bears much of the upper body’s weight as you lift, bend, and twist. Even though this is a powerful and flexible section of the spine, it is prone to injuries and other structural issues. 

In between each vertebra of your spine sits a disc that helps to absorb shock from everyday movements. Healthy discs have a tough, fibrous outer layer and a spongy inner layer. As we age, these discs have a tendency to dry out and lose their shape. In time, these discs may become damaged and alter the structure of the spine. As a result, nerves passing through tunnels in the vertebrae may become compressed or damaged. This can be a major source of back pain.

Of course, not all back pain is related to the vertebrae and discs. In fact, many of those suffering from back pain experience muscular problems due to repetitive movements, heavy lifting, or even moving in the wrong way. Muscular problems tend to clear up within a few days or weeks with proper self-care. 

But what if your back pain is not muscle-related? What if underlying issues affecting the discs, vertebrae, or facet joints are causing your discomfort?

Self-care and conservative treatments can help with the healing process. More severe cases, however, may require a surgical intervention like ALIF. Surgery helps to maintain spinal alignment and prevent further structural issues. 

What is an Anterior Lumbar Spine Fusion (ALIF)? 

An anterior lumbar spine fusion (ALIF) is one of a few surgical options for those seeking relief from lower back pain. 

During an ALIF procedure, the surgeon makes an incision in the front of the lower abdomen. (Don’t worry, you’re given anesthesia for the procedure. You will be asleep the entire time.) Oftentimes, a spine and vascular surgeon work together to complete the surgery. Why? Vascular surgeons ensure a clear path is made by moving aside blood vessels leading to and from the legs. 

Once a spine surgeon achieves access to the damaged disc, it is removed. The surgeon then fills the open space between the vertebrae with a bone graft. Bone grafts could come from a section of your hip or a bone donor. 

The graft restores height between the bones, which, in turn, relieves pinched nerves and helps stabilize the spine. Sometimes a surgeon uses metal plates and screws to reinforce the bone graft.

An ALIF surgery usually takes a couple of hours depending on how many levels of the spine are affected. Once the surgery is complete, you are moved to a recovery room for monitoring. As you wake, any immediate pain issues will be addressed.

ALIF Recovery

Most individuals receiving an ALIF go home a day or two after the operation if they have a support network at home. The length of your hospital stay often depends on the size of your incision, pain related to the surgery, and your ability to move around.

You may need to wear a back brace for comfort and to keep the area immobilized. Also, your doctor typically prescribes pain medications and physical rehabilitation as part of the recovery process.

Curious about when you can return to work? This often depends on the physical demands of your job. Typically, jobs that don’t require heavy lifting, bending, and twisting can have you back to work within a month or so. More physically demanding jobs may allow you to return in this time frame with some restrictions. 

In time, the vertebrae directly above and below the bone graft will fuse into one solid bone. This increases spinal structure and stability. Recovery time can take between 6 and 12 weeks.

What are the Advantages of an ALIF?

You may wonder why a surgeon has to pass through the abdomen area to get to the spine. It may seem a little strange. After all, wouldn’t it just be easier to do the fusion through an incision in the back? 

For some, the front approach works best. Temporarily moving the internal organs is easier than trying to work around the muscles in the back. 

But why?

  • Approaching a fusion surgery from the front helps surgeons avoid spinal nerves
  • Restoring a slipped lumbar vertebra is easier from the front
  • Operating time is shorter
  • An ALIF reduces the risk of some severe complications
  • Larger spacer devices can be used to increase the chances of a successful spinal fusion
  • Since the back muscles are not affected, you may experience less pain after surgery 
  • To possibly avoid multiple surgeries in the same area if you previously had a procedure using the back (posterior) approach.

In some cases, a minimally invasive ALIF procedure may be used. These techniques use a tiny camera and surgical tools to complete the spinal fusion. Minimally invasive procedures offer several advantages for patients including:

  • Smaller incisions and scars
  • Less blood loss during surgery
  • Reduced damage to surrounding tissue resulting in less preoperative pain
  • Quicker recovery times
  • Less reliance on potentially dangerous and habit-forming pain medications 
  • Shorter hospital stays meaning significantly less expensive medical bills 

ALIF Surgery Risks

ALIF surgery has many advantages. Of course, like any surgery, risks and complications are possible. Although rare, risks associated with ALIF include:

  • Blood vessel damage
  • Failure of bone graft to fuse
  • Hardware failures
  • Injury to the abdominal organs like the kidney, bladder, or colon.
  • Damage to the nerves or spinal cord

How Do I Know If I Qualify for an ALIF?

As with any spinal condition, you want to be sure to consult with an orthopedic doctor. Obtaining a proper diagnosis and exploring conservative treatment options are often necessary before considering an ALIF procedure.

You may qualify for ALIF if diagnosed with:

  • Degenerative disc disease: As discs wear out and lose shape, this can affect spinal structure and pinch nearby nerves leaving the spine.
  • Spinal stenosis: Enlarged facet joints and damaged surrounding soft tissues can pinch the nerves leading to the legs.
  • Spondylolisthesis: When a vertebra slips forward over the one below it. This change in the spine can pinch and compress nerves.
  • Scoliosis: A sideways curve in the spine often developing during childhood. Adults, however, can suffer from this condition due to arthritis, damaged discs, or previous spine surgery.
  • Fractured vertebrae: Accidents and other physical traumas can cause small breaks in the vertebrae. This can lead to structural problems with the spine. 

 ALIF may not be recommended if you have:

  • Not explored conservative treatments for at least a few months
  • Showed signs of infection or inflammation near the operative site
  • Poor bone quality in the lumbar spine like severe osteoporosis
  • Severe atherosclerosis of the iliac vessels or aorta
  • Peripheral vascular disease
  • Sensitivities to implant materials
  • Previous surgery to remove lymph nodes in the back of the abdomen (retroperitoneal surgery)
  • Obesity 
  • History of an aortic bypass or endovascular stent-graft

Ready to Find Out if an ALIF Procedure is Right for You?

At The Advanced Spine Center, our team of doctors and specialists take the time to get to know you, your condition, and your specific treatment goals. Together, we create a treatment plan using conservative and (if necessary) surgical treatments. 

Want a quick way to see what treatments may be right for you? Take a quick 2-minute guided pain assessment to start the process of finding a treatment that can help you get your life back. 

Of course, you could always give us a call at (973) 538-0900. We would love to help with proper diagnosis, second opinions, and, of course, treating the source of your back pain. Schedule a consultation today so you can enjoy a better tomorrow.