Anterior Lumbar Interbody Fusion (ALIF)

Operation
Also known as Anterior lumbar interbody fusion

Indication
Low back pain and degenerative disc disease to L4/5 or L5/S1

Pre-assessment
Yes

Pre-operative questionnaire
Click here

Special preparation for surgery
stop all blood thinning medications including aspirin, warfarin, clopidogrel.
Stop HRT and oral contraceptives. Stop some herbal medicines.
You will be advised when to stop these medications.

Admission to hospital
Night before surgery or on the day of surgery

General anesthetic
Yes

Operation position
Supine (on back)

Details of operation
Incision is made to the left of the umbilicus (belly button). Approach is made to the spine by retracting (holding out of the way) the abdominal contents. Special self retaining spinal retractors are used to gain a safe corridor down which to access the disc. The disc material is removed with specialized instruments. A spinal cage is filled with patient’s own bone (from a graft site) or a bone substitute and the cage is inserted in to the cleared disc space.

Length of surgery
1.5 – 3 hours

Urinary catheter required
Yes

Post-operative drain required
No

Post-operative antibiotics
Yes

Post-operative iv fluids (drip)
Yes Intravenous fluids and patient controlled analgesia

DVT prophylaxis
Yes – details tailored to individual patient

Mobilization after surgery
12 hours

Length of stay in hospital
1- 3 days

Post hospital recovery
2 weeks of gentle rest followed by 2 weeks gradually increasing to normal daily activities and a further 2 weeks of increasing to full activity level. Leave strenuous activities until after 6 weeks.

Sutures removed
Dissolvable

Dressing
Dissolvable

Review appointment
6 weeks with x-ray
12 weeks with x-ray
6 months with x-ray
1 year with x-ray
and then annual review

Physiotherapy
Yes

Return to driving
2-4 weeks

Return to work
4- 6 weeks