Anterior Lumbar Interbody Fusion (ALIF)

 

Anterior Lumbar Interbody Fusion (ALIF) is a surgical procedure in which one or more of the lumbar discs is removed and replaced with either a block of bone or a fusion device to allow the bone to fuse across the disc space. 

   

If You Have Decided to Have Surgery

          

• Call Dr. Jeffords’ staff to schedule your surgery date and the date for your pre-op consultation.
• At your pre-operative consultation Dr. Jeffords or his P.A. will discuss the procedure with you, answer any questions you may have, and have you sign a consent form for surgery.
• You will be given prescriptions for pain medicine and instructions for post-operative care.
• Your pre-operative evaluation at the hospital will be scheduled on the same day as your pre-operative consultation. You may have a chest X-ray, EKG, and blood-work performed.
• If you take aspirin or anti-inflammatory medications daily, STOP these medications at least 7 days before your surgery.
• If you are a smoker you should make every effort to stop smoking as soon as you can before surgery (at least 2 weeks prior to surgery). You should not smoke for at least 6 weeks after surgery.
• You will check into the hospital the morning of surgery.

Surgical Procedure: ALIF (Front)

• Your anesthesiologist will bring you to the operating room and put you to sleep for the operation.
• There are usually two nurses in the room and a certified surgical assistant that assists Dr. Jeffords with the operation.
• A general surgeon or vascular surgeon may assist Dr. Jeffords during the exposure of the spine.
• A small incision is made on the front of your lower abdomen, usually below or to the side of your “belly button”.

                     

• After carefully moving the muscle tissue and abdominal contents, retractors are placed to expose the front of the spine and hold the major blood vessels off to the side.
• Dr. Jeffords will then remove the disc and prepare the disc space for the fusion.
• Bone graft material is inserted into a plastic or metal fusion cage which is then inserted into the disc space.
• Dr. Jeffords may place a titanium plate over the disc space with screws that are placed into the bones above and below.

             

• The incision is closed with resorbable stitches that are placed beneath the skin.
• The surgery will take approximately 1-2 hours.

Surgical Procedure: (Back - If Needed) - Minimally Invasive Posterior Fusion

• In some cases the ALIF cage will be given extra support by placing screws and rods into the bones of the spine from the back (posterior).
• For this part of the procedure, you will be positioned lying face down.
• Either one or two small incisions will be made, depending on whether screws need to be placed on only one or both sides.
• X-ray imaging is used to guide the screws through the small incisions into the bones.
• The screws are then connected by rods to hold the spinal bones in their correct alignment as they heal and fuse through the ALIF cage.

            

          

After Surgery

• You will be taken to the recovery room (PACU) and stay there for about 1-1 ½ hours. Afterwards you will be taken to your hospital room where you can visit with your family.
• Dr. Jeffords will speak to your family while you are in the recovery room.
• The nurses will get you out of bed shortly after surgery and the physical therapists will work with you to ensure that you are strong enough to walk and climb stairs.
• Most patients go home the either the morning after surgery or the following morning, depending on their pain level, how well therapy is going, or other factors.
• You will be able to ride in a car or plane upon leaving the hospital.

After Going Home

• A small dressing is placed over the incision in the operating room. This dressing will stay on for 7 days. 
• You may shower over the dressing starting 48 hours after surgery.
• You will be given pain medication and a muscle relaxant to help control post-operative pain and spasms. Make sure you do not drive or operate heavy machinery while on the medication.
• Patients typically begin driving after 2-4 weeks, once they are off their medications.
• You can expect to return to sedentary office or desk work approximately 2-4 weeks after surgery and moderate duty at 4-6 weeks.
• If you perform manual labor that requires heavy lifting or frequent bending or climbing you should wait 3-6 months before returning to this activity.
• X-rays will be taken at each of your post-op visits. The fusion is usually seen to be solid by the 3 or 6 month visit.
• Sports activities such as golf or tennis may be resumed at 6 months.