Minimally Invasive Anterior Lumbar Interbody Fusion?
When certain conditions of the lower (lumbar) spine like Degenerative Disc Disease are present, and non-surgical methods have not provided significant relief for the patient, a Minimally Invasive Anterior Lumbar Interbody Fusion may be chosen.
Anterior procedures are surgeries which are approached from the front of the body, through neck or the abdomen. These types of surgery provide better access to the area of the spine to be treated and enable the surgeon to:
- Remove the degenerative disc and restore the disc to its original disc height
- Insert a bone graft to allow more space for the fusion, without disrupting the nerves at the posterior of the spine
- Place the bone in compression between the vertebrae, which provides a better fusion environment
- Open up the disc space, effectively decompressing the nerve roots leading out of the spinal canal (the foramen)
The Anterior approach also allows the surgeon to directly access the disc from the front to avoid manipulating the nerve roots, which are on the posterior section of the spine. In addition, no muscle dissection is required to gain access to the front of the spine. “Lordosis” is the natural curve of the lumbar spine, and using the anterior approach helps restore that natural curve. Restoring lordosis helps decrease fatigue of the surrounding back muscles.
The Interbody Fusion Procedure involves removing the flattened, damaged disc that lies between the two vertebrae. It is then replaced by a bone graft from the patient’s own body, or from a cadaver. Cages or other devices are sometimes implanted around the surgical site to help provide stability while the bones are in fusion (while they “meld” together).
Patients over 60 years of age may not be good candidates for this procedure, nor is it advisable for patients with osteoporosis. Conditions typically suitable for the ALIF Surgery are Degenerative Disc Disease and Lumbar Foraminal Stenosis. Conditions that are not usually treated with ALIF include any pathology that is mostly posterior, including:
- Isthmic Spondylolisthesis
- Degenerative Spondylolisthesis
- Lumbar Spinal Stenosis