CHAPTER 21
ATERIOR LUMBAR
ITERBODY FUSIO (ALIF)
(This is the section that explains the detail of the operation or procedure
above and should be read in conjunction with the chapter Your Back
Operation).
An anterior lumbar interbody fusion (ALIF) is performed to remove a dam-
aged disc. The aim of the operation is to remove the whole disc and to replace
it with a spacer and bone chips harvested from your hip (iliac crest) or from
donor bone to allow a fusion to grow with time between the two adjacent ver-
tebrae where the disc originally was. This means that the mobility of that sec-
tion is removed by the growing fusion.
The reason why the disc is removed is because the disc is causing local back
pain and referred pain through inflammation or pain down the leg due to the
compression of a nerve root.
The idea behind replacing the disc that is removed with a spacer and bone or
bone alone, is to remove the origin of the pain, recreate the natural spinal
curve, to remove the compression of the nerve structures and finally to create
a solid bone block. This creation of a solid bone block does not happen before
one year or even longer after the operation. The advantage of operating on the
spine from the front is that most of the surgery takes place in front of the
spinal canal, and not around the nerves. The further advantage is that in the
ALIF procedure there is no or minimal damage to the spinal muscles, which
are very important in the normal mobility and stability of the spine.
133