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LisaRachelLLisaRachel Posts: 286
edited 06/11/2012 - 8:47 AM in Back Surgery and Neck Surgery
What is ALIF?



  • Anterior lumbar interbody fusion. Here's the link from here. :)


    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Anterior Lumbar Interbody Fusion

    Basically, it is spinal fusion but approach through the front (abdomen). A skillful general or vascular surgeon will actually do the approach and open a window to your spine so your NS or OS can perform the fusion.
    You can enter ALIF in the search feature (above) for articles, posts & other info.

  • Where are they doing your incisions? I think mine will be the back and side. I think that's called "posteriolateral" but I'm not sure (my surgeon just said "back and side" at the last appointment, LOL!)
  • Thank you everyone! I have been reading posts and not understanding some of the short term words.

    I'm having my surgery in the back but I'll find out more on the 25th with my doc.

    I'm having a new problem but this is with my ankle. I have a large lump above one of the screws it's very swollen and painful to walk. So, I have been limping and now my back is so sore :(

    Wow, ALIF sounds a lot worse then just doing it from the back!

  • Hi Lisa,

    Even though doing a lumbar fusion from the anterior approach sounds worse than the posterior, that may not always be the case. The anterior approach eliminates the need to strip (fillet) the muscles off the back of the spine when going in through the posterior approach. The recovery time with a posterior approach (PLIF) can be longer than with an ALIF because of the disturbance to the muscles. Which way the surgeon enters is a judgment call he has to make after taking all things about your back into consideration. My PLIF was just 3 weeks ago and I'm doing extremely well, with little or no pain at the surgical site and my muscular pain is well controlled with Robaxin. I am having nerve pain in my right leg which is being treated with Lyrica but I'm not surprised since the L5 nerve root had been increasingly more pinched over the last 6-7 years.

    We'll be thinking about you when you have your surgery! Will check on you in the November surgeries thread. :)


    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • Yes, I would think doing a 360 fusion via full posterior would require a very large incision! Mine will, as I said, have a posterior and lateral incision (but I found out posterolateral refers to where they enter the spine, not where the incision is, so was wrong about that).

    Unfortunately, I don't think they can do the L1/2/3 fusion via anterior, and I know at least for my surgeon, another surgeon will be coming in to assist with the lateral part of the surgery. So maybe some surgeons prefer to do it posterior only?

    I'm assuming everyone gets a 360 degree fusion after a vertebrectomy. Would anything else be stable enough?
  • I had ALIF on l4/l5 ,the surgery wasnt that bad.I went home the next day,no muscles were cut and you can hardly see a scar.
  • Berg, sounds like you had a very good outcome.
    I had L4-5 ALIF and was in hospital for 5 days. My surgery went well, my incision is thin, thanks to talented vascular surgeon, but nonethelessvits about 5 inches in length and is from belly button down. No more happy trail; replaced by boo boo trail. Did you have a bone graft taken from hip?
    Did you have a traditional open ALIF or a minimal invasive procedure?
    Very curious to hear.
  • It was a traditional ALIF no bone graft I had BMP instead,its the recovery part that stinks,Im one year post op and I still have alot of new post op pain bad enough to where I cant do much.
  • i am surprised because i am waiting for the very same operation {3 levels} but i have been told that i will be in hospital for at least 5 days more like 9 days ..are you sure it was an ALIF?? even when i went in for a two level discectomy i was in hospital for 3 days .how are you dong with your recover ? because i have been told its a very hard operation to recover from and i have been told by my consultant that it should take around 36 months {3 years } to fully recover .or to get to be as good as i am ever going to be ..i will be having the open procedure as my surgeon likes to see what he is doing ..many laparoscopic operation are turned into open operation as things start to go wrong so he now dose all his ALIF fusion in the open style .
  • Tomorrow and I can not do much of anything!
    Obviously, not working. Sitting is awful for me 20 min in a good comfy chair, about 5 minutes or less in a not so comfy one.
    I have lots of pain, back, legs, abdomen.......
    Lots of odd nerve sensations, some new others are pre existing, but perhaps more intense. Even standing is hard for me, 8 have to lean on things, wall, rails, walker, cane.
    How long did it take you to feel "normal" again. Do you feel normal?
    I am on MORE pain meds post op, then pre operatively.
    My quality ok life is not good, I'm not depressed, I suffer from chronic pain! I barely sleep. I went with the ALIF route as NS said it had a quicker recovery time compared to going through back.
    When did you go back to work? If you are working.....?
    Any post op complications?
    Did you get screws in back or abdominal plate?
    Thanks for sharing Breg, I look forward to your reply.

  • Straker, I think a lot depends on what they do to your spine. The "A" only refers to the incision.

    I think your spine is going to require a lot of work (multiple fusion, etc). Lisa and I are getting L2 vertebrectomy and 2 level fusions. Others get various other procedures. I imagine the recovery from a single level uncomplicated ALIF would be MUCH different than a multi-level ALIF with a lot of work.
  • Happy, although I did only one level, which I now know was too conservative, seeing, I have issues at two other levels and MOST problematic is the level right above which has bulging disc and foraminal narrowing bilaterally with more then 50% of disc height loss. I fear that level is now a ticking time bomb! Two other NS wanted to do both levels posterior approach to include full foramanotmy to deal with the stenosis.
    I played the conservative road since 2003 and when push came to shove and there was no way around the fusion, I wanted to the least and quickest recovery procedure. To get back to work & living a "normal" life again. I went with the worst disc L4-5, which was 100% collapsed, bone spurs everwhere, endoplated changes and loss of signals, vertabre was buckling.

    In fact I feel my procedure (itself) went well but it didn't correct all my issues, my disc height has been restored at that level, the osteophytes were drilled out (anterior - I still have bone spurs at that level posterior, that were not addressed as my approach was from the front). I limited my outcome by limiting the procedure. Retrospect......powerful!

    Unfortunately, I have been dealing with a few complications which has been frustrating, trying to deal with them one at a time.

    My NS says the foraminal narrowing & stenosis at the fused level should be decompressed via the tall cage and wedge he used, which can only be achieved with an ALIF.
    We will see....

    I have a consult with another NS to review my post op MRI which was taken at 12 days post fusion.

    At almost 9 weeks, I don't know what I should expect from myself, it is discouraging, the amount of pain & physical limitations I am facing.

    Straker, you will be facing a lot of surgery, I have been following your case over the past two months, and you seem to have a clear understanding of what your surgery will be and per your post your doctor is truly giving you a realistic outcome.

    Wishing all a nice low pain day! (3's or better)

  • Yes Im sure it was an ALIF,my recovery has been-is pure hell,I have all kinds of new post op pain back,hip,butt left leg numbness,wierd nerve sensations in my groin,peralaysis when I lay down I cant even begin to sit up I can only raise my head the rest of my body doesnt even respond.
  • Hi virginiap
    Sorry to say but I dont feel even close to normal.I was off all meds one week post op my choice,now here I am one year later and I just went back on them, I just couldnt take the constant pain anymore it was wearing me down.I went back to work in construction after seven weeks,light duty only for five months until they fired me because I couldnt work full duty .I was given a whole two hour notice no thank you no good bye nothing, and here I worked thier for over twelve years,to hell with them my life goes on.AS far as post op complications I have several back,hip,butt to name a few.The hardware I have is a plastic cage filled with BMP and two titanium screws
    one in L4 the other in L5.should you have
    any other questions feel free to ask.I wish you well on your recovery I hope it goes better than mine
  • with every fusion there is a bone graft? my surgeon told me my hip where they are taking the bone will be worse then my spine. Have any of you experienced this? I went to see my surgeon today he said no brace. I think recovery time is also based on how healthy are bodies are to start with. After I broke my back the doctor's in France told me I was very lucky to be walking, he said that if I was overweight it might have turned out worse for me.
  • No, sometimes they use cadaver bone.
  • Hi Lisa,

    From what I've heard from others, the pain in the hip from removal of the bone can be quite a bit worse than the surgical site pain. I had posterior fusion and didn't need bone removed from my hip because my autograft was done using the long lamina propria which protrude from the spine in the lumbar area. He ground them up, added bone substitutes, and put it all into cassettes that went between my vertebrae as spacers. I have had no pain whatsoever from the removal of the lamina.

    I'm a little surprised your surgeon would tell you no brace. Maybe he isn't going to use screws?? Mine told me that when he put the screws in if he didn't hear them squeek he would know that my bones were soft and I'd end up in some kind of a brace. Unfortunately, that's exactly what happened, thus the rigid brace which I'm wearing. If you know you're having screws placed during the fusion, I would think you'd be in the same situation where the surgeon wouldn't know if he had healthy bone until he put the screws in.

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • On the other hand, Virginia, you can look at it the way I'm looking at it- you just can't fuse 'em all! If I fused everything that had narrowing of the disk space or a bulging disk or something like that, I would never pick up a piece of paper off the ground again ;)

    At least that's the way I'm looking at it prior to seeing my surgeon on Thursday!

  • I did have bone graft taken from illac crest & they did also use the shavings from the large bone spurs they drilled from the front of the vertabre. Surgeon also used bmp compound as well, I had a very tall cage.

    I had to wear the brace! Hard rigid full back, for 7 weeks, now I wear the breakdown part, black corset, pull strings with velcro.

    Yes, the graft site hurts, but not more then my residual back, hip & leg pain. Just my experience.

    From my understanding most ALIF cases require a brace.

  • Remember that Lisa, like me, will have a cage replacing an entire vertebrae as well as two discs! So that will be a lot of bone :)
  • I know you are right, I had one NS who wanted to do 3 levels, I ran (or limped) out of there!
    Not so much the disk height or even the buldge, its more the foraminal stenosis at the L3-4; which is contacting the nerve root, that I now regret not doing it. (2 NS said should do it)
    I can actually feel more stress on that area, yikes!
    Plus the discogram.... but I took what I thought was the easy road.....
  • He's not putting in the cage so, I'm going to be 4.9 feet I'm 5ft now. My SP said it would be too diffilcult. They already call me the little one.... HB- I'm not sure i'm having a 2level fusion I thought it was just one.
  • So he's just taking out the vertebrae and leaving it? Hmmm. Interesting!
  • Lisa, have you had a second opinion on this?
  • He's putting in rods and screws to hold it together thats why I'm not going to be wearing a brace. Is that a good intersting or a bad interesting? Your having a 2level fusion with a cage? where the L2 was..
  • Lisa I would ask you surgeon if he has done this before. I would think changing the length of your spine would impact other things. Maybe it's low enough that it would be OK but it would be a good question.
  • I have asked him if he has done these type of surgeries, he sais yes but he usually does in them people 65 and older I'm 39. At first he said he was using a cage but he changed his mind. But yes that is a good question I wrote it in my book I'm going to see him on the 18th after my pre-op..
  • It just doesn't sound like any vertebrectomy I've ever heard of, but that doesn't mean much! Having a second opinion never hurt anyone :)

    If it were me, I'd wonder how a vertebrectomy would work without a cage to replace the vertebrae.
  • From what I've seen from other posts, what happened to you is not unique. It really blows that you probably busted your butt & literally your back for that company and then bam, fired!

    I haven't returned to work, at this point its physically impossible, like you, I can't do much of anything! Plus the small pharmacy of meds in my kitchen prohibit me from doing almost everything.

    I'm beginning to wonder does anyone get better from a fusion? Sorry just felling a little discouraged :o(

    Its funny I know a lot of people that walked blindly in to back surgery, NOT FUSION, actually most don't even now what they had done, u hear..."they went in and CLEANED IT UP or CLEANED IT OUT", I am like cleaned what out??, They have no clue and those people are fine! Me who spent years researching & avoiding trying everything under the sun, came out worse.....I am still HOPEFUL I will wake up and be ok... soon I hope! I keep telling myself, another week.....

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