Anterior lumbar interbody fusion (ALIF) is a spinal fusion procedure usually performed at L5/S1 or L4/5.
The anterior approach is often selected in preference to other lumbar interbody fusion approaches due to it providing a superior view of the vertebrae as well as avoiding damage to posterior musculature 3.
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Indications
See: lumbar interbody overview (overview).
Procedure
ALIFs are carried out either via a transabdominal or lateral retroperitoneal approach. A discectomy is performed, an interbody spacer is introduced and fixed in place with screws with or without a supporting plate (depending on the hardware design) 1.
In some instances, the procedure needs to be combined with posterior instrumented fusion with pedicle screws and rods 1.
Complications
Complications associated with this procedure are rare, however, those that may occur have the potential to cause significant morbidity. Damage to anatomical structures intraoperatively is a mechanism for several complications. Structures that may be damaged can include: vascular (such as the great vessels), neurological (most pertinently the superior hypogastric plexus), intestines or the ureters. Postoperatively, pseudoarthrosis remains a concern as well as loss of lordotic curvature 2,3.