Indications for Anterior Lumbar Interbody Fusion

Abstract

Anterior lumbar interbody fusion (ALIF) has become a widely recognized surgical technique for degenerative pathology of the lumbar spine. Spinal fusion has evolved dramatically ever since the first successful internal fixation by Hadra in 1891 who used a posterior approach to wire adjacent cervical vertebrae in the treatment of fracture-dislocation. Advancements were made to reduce morbidity including bone grafting substitutes, metallic hardware instrumentation and improved surgical technique. The controversy regarding which surgical approach is best for treating various pathologies of the lumbar spine still exists. Despite being an established treatment modality, current indications of ALIF are yet to be clearly defined in the literature. This article discusses the current literature on indications on ALIF surgery.

Stand-alone anterior lumbar interbody fusion for treatment of degenerative spondylolisthesis

“…Restoration of intervertebral height indirectly decompresses the exiting nerve roots by increasing neuroforaminal volume [2,3]. ALIF has also been shown to restore lumbar lordosis and sagittal balance [3,4,6,7]. High fusion rates are reported, even across different indications for ALIF [1,3,4].…”

“…First described in 1932 by Capener, anterior lumbar interbody fusion (ALIF) is another technique for treating the degenerative and isthmic forms of spondylolisthesis [1][2][3][4][5]. The chief advantage of ALIF is excellent exposure, which permits thorough discectomy and placement of a large, wedge-shaped, lordotic device [3,4].…”

Radiological and clinical outcomes of novel Ti/PEEK combined spinal fusion cages: a systematic review and preclinical evaluation

“…This is optimally achieved by correcting the structural deformity to its anatomic baseline and the stabilization of the segment, concurrently preventing further unnecessary and painful motion [2]. Indications for interbody fusion broadly include cases of chronic pain, deformity and instability of the spine [3,4].…”

L5/S1 anterior lumbar interbody fusion technique

“…The LIF involves placement of an implant device following discectomy and endplate preparation (2,3). ALIF was first described in the treatment of Pott's disease (4), and over time, ALIF procedure has been studied extensively and is now a commonly performed procedure for degenerative lumbar spinal disease (3,5). Unlike the PLIF technique, the anterior approach does not require access through the spinal canal with retraction of the nerve roots and cauda equina.…”