Anterior lumbar interbody fusion (ALIF)

Last revised by Arlene Campos on 12 Jan 2024

Anterior lumbar interbody fusion (ALIF) is a spinal fusion procedure usually performed at L5/S1 or L4/5. 

The anterior approach is often selected in preference to other lumbar interbody fusion approaches due to it providing a superior view of the vertebrae as well as avoiding damage to posterior musculature 3.

See: lumbar interbody overview (overview).

ALIFs are carried out either via a transabdominal or lateral retroperitoneal approach. A discectomy is performed, an interbody spacer is introduced and fixed in place with screws with or without a supporting plate (depending on the hardware design) 1

In some instances, the procedure needs to be combined with posterior instrumented fusion with pedicle screws and rods 1

Complications associated with this procedure are rare, however, those that may occur have the potential to cause significant morbidity. Damage to anatomical structures intraoperatively is a mechanism for several complications. Structures that may be damaged can include: vascular (such as the great vessels), neurological (most pertinently the superior hypogastric plexus), intestines or the ureters. Postoperatively, pseudoarthrosis remains a concern as well as loss of lordotic curvature 2,3

ADVERTISEMENT: Supporters see fewer/no ads