Anterior approach to the lumbar disc space for placement of wide variety of grafts/disc spacers and instrumentation
Advantages
The hope: Circumferential fusion with grafting will improve fusion rates and clinical outcomes
Anterior fusion places graft in optimum position for load-bearing
Load-bearing increases potential for fusion
Restores disc height
Restores lordosis
Restores sagittal balance
Avoids paraspinal muscle trauma
When combined with minimally invasive posterior fixation
Indirect decompression of neural foramen by increasing disc height
PRE-PROCEDURE
Indications
Contraindications
Pre-Procedure Imaging
PROCEDURE
Procedure Steps
Alternative Procedures/Therapies
POST-PROCEDURE
Expected Outcome
OUTCOMES
Problems
Complications
Selected References
Strube P et al: Stand-alone anterior versus anteroposterior lumbar interbody single-level fusion after a mean follow-up of 41 months. J Spinal Disord Tech. 25(7):362-9, 2012
Wang MY et al: Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients. J Spinal Disord Tech. 25(6):324-8, 2012
Anderson DG et al: Anterior interbody arthrodesis with percutaneous posterior pedicle fixation for degenerative conditions of the lumbar spine. Eur Spine J. 20(8):1323-30, 2011
Epstein NE: Pros, cons, and costs of INFUSE in spinal surgery. Surg Neurol Int. 2:10, 2011
Ho JM et al: Toward the establishment of optimal computed tomographic parameters for the assessment of lumbar spinal fusion. Spine J. 11(7):636-40, 2011
Lindley EM et al: Complications of axial lumbar interbody fusion. J Neurosurg Spine. 15(3):273-9, 2011
Smoljanovic T et al: Six-year outcomes of anterior lumbar interbody arthrodesis with use of interbody fusion cages and recombinant human bone morphogenetic protein-2. J Bone Joint Surg Am. 92(15):2614-5; author reply 2615-6, 2010
Hodges SD et al: Intraoperative loosening of Bagby and Kuslich cages during anterior lumbar interbody fusion. J Spinal Disord. 13(6):535-7, 2000
Kuslich SD et al: Four-year follow-up results of lumbar spine arthrodesis using the Bagby and Kuslich lumbar fusion cage. Spine (Phila Pa 1976). 25(20):2656-62, 2000
Bagby G: The Bagby and Kuslich (BAK) method of lumbar interbody fusion. Spine (Phila Pa 1976). 24(17):1857, 1999
Rajaraman V et al: Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg. 91(1 Suppl):60-4, 1999
Kuslich SD et al: The Bagby and Kuslich method of lumbar interbody fusion. History, techniques, and 2-year follow-up results of a United States prospective, multicenter trial. Spine (Phila Pa 1976). 23(11):1267-78; discussion 1279, 1998
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Pre-Procedure
TERMINOLOGY
Abbreviations
Anterior lumbar interbody fusion (ALIF)
Anterior approach to the lumbar disc space for placement of wide variety of grafts/disc spacers and instrumentation
Advantages
The hope: Circumferential fusion with grafting will improve fusion rates and clinical outcomes
Anterior fusion places graft in optimum position for load-bearing
Load-bearing increases potential for fusion
Restores disc height
Restores lordosis
Restores sagittal balance
Avoids paraspinal muscle trauma
When combined with minimally invasive posterior fixation
Indirect decompression of neural foramen by increasing disc height
PRE-PROCEDURE
Indications
Contraindications
Pre-Procedure Imaging
PROCEDURE
Procedure Steps
Alternative Procedures/Therapies
POST-PROCEDURE
Expected Outcome
OUTCOMES
Problems
Complications
Selected References
Strube P et al: Stand-alone anterior versus anteroposterior lumbar interbody single-level fusion after a mean follow-up of 41 months. J Spinal Disord Tech. 25(7):362-9, 2012
Wang MY et al: Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients. J Spinal Disord Tech. 25(6):324-8, 2012
Anderson DG et al: Anterior interbody arthrodesis with percutaneous posterior pedicle fixation for degenerative conditions of the lumbar spine. Eur Spine J. 20(8):1323-30, 2011
Epstein NE: Pros, cons, and costs of INFUSE in spinal surgery. Surg Neurol Int. 2:10, 2011
Ho JM et al: Toward the establishment of optimal computed tomographic parameters for the assessment of lumbar spinal fusion. Spine J. 11(7):636-40, 2011
Lindley EM et al: Complications of axial lumbar interbody fusion. J Neurosurg Spine. 15(3):273-9, 2011
Smoljanovic T et al: Six-year outcomes of anterior lumbar interbody arthrodesis with use of interbody fusion cages and recombinant human bone morphogenetic protein-2. J Bone Joint Surg Am. 92(15):2614-5; author reply 2615-6, 2010
Hodges SD et al: Intraoperative loosening of Bagby and Kuslich cages during anterior lumbar interbody fusion. J Spinal Disord. 13(6):535-7, 2000
Kuslich SD et al: Four-year follow-up results of lumbar spine arthrodesis using the Bagby and Kuslich lumbar fusion cage. Spine (Phila Pa 1976). 25(20):2656-62, 2000
Bagby G: The Bagby and Kuslich (BAK) method of lumbar interbody fusion. Spine (Phila Pa 1976). 24(17):1857, 1999
Rajaraman V et al: Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg. 91(1 Suppl):60-4, 1999
Kuslich SD et al: The Bagby and Kuslich method of lumbar interbody fusion. History, techniques, and 2-year follow-up results of a United States prospective, multicenter trial. Spine (Phila Pa 1976). 23(11):1267-78; discussion 1279, 1998
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