An anterior lumbar interbody fusion surgery is performed from the anterior (front). Like other types of fusion surgery, its purpose is to stop the motion at the painful segment of your spine.

See Lumbar Spinal Fusion Surgery

Our video walk-through provides a step-by-step explanation of this relatively common procedure.

See Anterior Lumbar Interbody Fusion (ALIF) Surgery

ALIF (Anterior Lumbar Interbody Fusion) VideoALIF surgery is performed in close proximity to major blood vessels, which poses a potential risk. Watch: ALIF (Anterior Lumbar Interbody Fusion) Video

Video highlights

An ALIF is performed in your lumbar spine (lower back). The two segments in your lumbar spine that are most likely to require a fusion are pictured below: the L4-L5 and L5-S1 regions.

See Lumbar Spine Anatomy and Pain


Typically, an ALIF is performed to treat symptoms from lumbar degenerative disc disease (shown below).

See Lumbar Degenerative Disc Disease Symptoms

It is important to note that, if additional stability is needed, your surgeon may combine the ALIF procedure with a posterior approach.

See Anterior and Posterior Lumbar Fusion Surgery

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The procedure

To begin, your surgeon will make a 3 to 5-inch incision on the left side of your abdomen.

Next, he or she will move your abdominal muscles (pictured above in purple) to the side. These muscles do not need to be cut because they run laterally and are easily retracted.

The contents of your abdomen are contained in a large sack called the peritoneum. Your surgeon will retract your peritoneum to the side, which allows him or her access to your spine without having to enter your abdomen.

Next, a vascular surgeon will typically step in to assist in moving your large blood vessels; the aorta and vena cava. These are situated on top of your spine, and will be moved to the side.

Your surgeon will then remove the disc material from your affected disc.

After this, your surgeon will place a type of implant called a cage (pictured above) in the disc space to help restore normal spacing between your vertebrae. This cage will also minimize pressure on your nerve roots.

See Spinal Cord and Spinal Nerve Roots

Your surgeon will next place bone graft both in the cage and in front of the cage. They may also insert screws through the cage for additional stability.

See Anterior Lumbar Interbody Fusion Spinal Implants and Bone Grafts

If you are using your own bone graft, your surgeon will take bone morsels from your iliac crest (hip bone) at the same time as your fusion surgery. You may also have the option to use a synthetic bone graft.

See Bone Graft for Spine Fusion

ALIF outcomes

The above image shows the results as the bone graft heals together following ALIF surgery. The fusion has created one long bone between the vertebrae, and immobilized that segment of the spine.

See Potential Risks and Complications with ALIF Surgery

Fusion rates for ALIF should be between 90 to 95 percent. But not all patients who have a nonunion require an additional fusion procedure. If your joint is stable, and your symptoms have improved, you may be able to avoid another surgery.

Learn more:

Postoperative Care for Spinal Fusion Surgery

Spine Fusion Risks and Complications