ALIF
A type of spinal fusion surgery performed through the tummy.
ALIF key points
- ALIF or Anterior Lumbar Interbody Fusion is a type of spinal fusion surgery whereby the incision is made from your front, through the tummy.
- It is one of the few truly keyhole surgeries; none of the back muscles, bones or ligaments are injured.
- Technically this type of spinal fusion surgery is demanding and surgeon experience is key.
- In experienced hands, ALIF surgery is a safe procedure and the vast majority of patients are very happy with the result.
ALIF | Spine surgery Brisbane
The surgeon said ALIF. What exactly is that?
ALIF stands for Anterior Lumbar Interbody Fusion, but that’s not even the full name of the surgery. It’s actually “anterior lumbar interbody fusion, rhizolysis, vertebral body fixation.” Fancy names aside, it describes spinal fusion surgery whereby the surgeon simply approaches the spine from your front (through the tummy).
There are several advantages to approaching the spine through the tummy. The biggest and most obvious advantage is that none of the back muscles, bones or ligaments are affected by surgery. In fact, other than a skin cut, no other spinal tissue has to be cut to perform this operation. It is one of the few truly keyhole operations.
Learn more about the important, and commonly misunderstood concept of keyhole surgery here.
ALIF is technically more demanding than the other ways of approaching the spine and this is why experience is paramount. Each ALIF at my centre is performed by two surgeons per case. Two sets of experienced eyes make this a much safer, successful and quicker operation for you.
Spinal surgeon Brisbane
There are complex factors dictating why a spinal fusion should be performed from the front in one patient, and in other cases from the side or from the back.
When I see you I will look at all these factors and work out what is best for you, your symptoms and your lifestyle.
ALIF surgery success rate Brisbane
Is it successful?
Yes, it is.
It is not like in the past where the surgeries were very big and invasive, with really long recovery times. Modern technology and techniques have vastly improved this operation, making the surgery smaller, and the recovery more rapid.
The vast majority of patients that go through the modern ALIF position are very happy with the result. The goal of surgery is to improve your quality of life: for some patients this may mean they’re just pain-free, for others it may mean to be back on the golf course or in the gym, and for some it may mean they’re able to walk and move freely again.
Spinal surgeon Brisbane
I will consider all the important factors with you and determine what is best for you and the quality of life that you want to achieve.
ALIF surgery risks
Is it safe?
Yes, in experienced hands ALIF surgery is safe.
Modern technology and computer-guided systems have made the ALIF procedure a safe and effective operation. Improvement is ongoing with engineers from around the world continuing to push the limits of this technology.
With all this in mind the risks I will discuss with you are:
- The operation may not work: You may continue to have the symptoms despite ALIF surgery. This is now quite rare.
- The hardware may fail: Despite all the engineering that goes into the spacers and screws, very rarely these screws and spacers may move, break or fail.
- Bleeding: This rarely causes a problem.
- Infection: This is rare in modern surgical practice:
- Antibiotics. When these were invented in the 1940s, surgery was utterly transformed.
- Proper skincare during and after surgery. Healthy skin is a vital barrier to infection: ‘If you look after the skin, the skin will look after you!’
- Shorter surgery. While there is no cut-off point, it is well recognised that the more efficient the surgery, and the less time is taken, the lower the risk.
- General risk of the anaesthetic like clots in the legs, clots in the lungs, urinary tract infections, skin injuries from being on a bed for a long time, and heart or kidney problems. Modern anaesthetic medicine makes many of these risks very low.
I am committed to getting the best possible result for you and minimising the risks. This also includes keeping regular contact with you during the recovery phase.
There are 2 long term side effects I will talk to you about when I see you:
- Adjacent level disease
- Failure of fusion
In Australia, the ALIF operation is much less common than the other spinal fusion operations because of the experience required to do it safely and effectively. Each ALIF procedure at my centre is performed by two surgeons per case. Two sets of experienced eyes make this a much safer, successful and quicker operation for you.
You will have a general anaesthetic (i.e you will be ‘knocked out’ for the whole surgery).
The incision is made below the level of the belly button and just off to either the right or left (it depends on your specific case as to which side I will use). After this there is nothing else that gets cut, making this one of the few truly keyhole operations.
After dissecting down underneath all the muscles, all the tummy contents (including the intestines) get swept over to one side. This reveals the spine. There are large blood vessels that still stand in the way, and these get gently swept to one side to completely uncover the spine. After this the disc gets removed and a spacer with some small screws gets locked in place.
The anterior approach has minimal pain as no muscle is cut during the surgery. Occasionally some flank discomfort is felt for a couple of weeks, and occasionally thigh discomfort is felt, but this usually returns to normal.
ALIF surgery alternatives
Are there any other good options?
There are 2-3 options available for any one case, differing in the pros and cons. I will present these to you.
This is always an option. I will explain to you what this would look like for your symptoms and quality of life moving forward so you can make an informed decision.
ALIF surgery recovery time
What can and can't I do afterwards?
To get the best result you need to commit to a full recovery period. That is important because you will miss out on significant benefits in the long term when you bail out early. I often say, ‘recovery is like compound interest’; if you do the time, you’ll get the best result.
‘Recovery’ doesn’t equal ‘just rest’. I will actually encourage you to be as active as possible. It is very important to get your confidence back as soon as possible, and you will be surprised how much you are allowed to do straight after surgery.
This really depends on how fit you are and how many parts of your spine are fused. On average, plan for about 1-4 days in the hospital.
The scar in this part of the lower tummy region actually heals up quite nicely. It will never disappear but often it is hard to see after a few months.
I recommend a minimum of 2 weeks off work to get your confidence back and feel comfortable.
Physiotherapy has a very important role postoperatively. It helps reduce the muscle soreness and stiffness from the surgery.
Spinal surgeon Brisbane
What else do I need to know?
If you would like me to assess your condition please contact my team to book an appointment.
Ready to make an appointment?
Alex consults from the private Neurosurgery clinic at Greenslopes Private Hospital.
Lobby Level
Greenslopes Private Hospital
Newdegate St
Greenslopes QLD 4120
