What is miniopen – ALIF (Anterior Lumbar interbody fusion) procedure?
ALIF is a minimally invasive treatment for patients who primarily have discogenic back pain. The aim of this procedure is to obtain solid lumbar fusion to treat back pain by using an anterior approach (operating from the front of the spine) without disturbing or violating the back muscles, their nerves and blood supply which can lead to more back pain and leg pain.
How is it done?
Under general anesthesia and through a miniopen approach, the surgeon makes a small incision, usually on the left side of the lower abdomen, to expose the front part of the spine by going around the back of the abdominal cavity along the back wall without having to go through the abdominal cavity or cut through any of the back muscles. After disc material is removed from the front of the spine, a synthetic cage with bone graft and screws are inserted into the empty disc space and bone to support, stabilize and create lumbar fusion, and at the same time restoring disc height and spinal alignment into its natural lumbar curvature. Surgery usually takes about 2 to 3 hours to perform for a one or two-level procedure.
Why is it done?
Spinal disc degeneration and micro-instability of the lumbar spine can cause mechanical back pain, buttock, groin and hip pain, and nerve root irritations resulting in leg pain. This procedure is designed to stabilize the spine by achieving higher fusion rates to relieve back pain and their associated symptoms, without interfering with nervous tissues thereby avoiding scar formation around nerve roots.
Indications for ALIF procedure
- Discogenic back pain (single or multiple level, including L5/S1)
- Low grade lumbar spondylolisthesis- bone slip
- Spinal instability
- Lumbar spondylosis
- Degenerative disc disease
- Failure of previous posterior lumbar fusion surgery with pseudoarthrosis
- Combined with posterior procedure to enhance bone fusion
- Correction of lumbar deformity
Alternatives to spine surgery
- Weight loss
- Back exercises
- Physical therapy and rehabilitation program
- Hot/cold therapy
- Ultrasound therapy
- Spinal traction
- Epidural steroid injections
- Facet or SI joint block
- Radiofrequency treatment
Risks and complications
As with any spinal surgery, the risks include:
- Bleeding from blood vessels
- Nerve injury causing leg pain, weakness and numbness, or urinary and defaecation problems
- Retrograde ejaculation/infertility in men
- Wound Infection
- Complication related to instruments
- Blood clot in the legs (deep vein thrombosis), and pulmonary embolism
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