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Anterior Lumbar Interbody Fusion
Jeffrey S. Ross, MD
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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

                      1. 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
                      2. 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
                      3. 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
                      4. Epstein NE: Pros, cons, and costs of INFUSE in spinal surgery. Surg Neurol Int. 2:10, 2011
                      5. 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
                      6. Lindley EM et al: Complications of axial lumbar interbody fusion. J Neurosurg Spine. 15(3):273-9, 2011
                      7. 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
                      8. Hodges SD et al: Intraoperative loosening of Bagby and Kuslich cages during anterior lumbar interbody fusion. J Spinal Disord. 13(6):535-7, 2000
                      9. 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
                      10. Bagby G: The Bagby and Kuslich (BAK) method of lumbar interbody fusion. Spine (Phila Pa 1976). 24(17):1857, 1999
                      11. Rajaraman V et al: Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg. 91(1 Suppl):60-4, 1999
                      12. 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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                      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

                                          1. 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
                                          2. 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
                                          3. 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
                                          4. Epstein NE: Pros, cons, and costs of INFUSE in spinal surgery. Surg Neurol Int. 2:10, 2011
                                          5. 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
                                          6. Lindley EM et al: Complications of axial lumbar interbody fusion. J Neurosurg Spine. 15(3):273-9, 2011
                                          7. 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
                                          8. Hodges SD et al: Intraoperative loosening of Bagby and Kuslich cages during anterior lumbar interbody fusion. J Spinal Disord. 13(6):535-7, 2000
                                          9. 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
                                          10. Bagby G: The Bagby and Kuslich (BAK) method of lumbar interbody fusion. Spine (Phila Pa 1976). 24(17):1857, 1999
                                          11. Rajaraman V et al: Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg. 91(1 Suppl):60-4, 1999
                                          12. 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