Anterior lumbar interbody fusion oxnard alif surgery. The approach to the spine can also vary but in this case will be from the front, through the abdomen, by anterior lumbar interbody fusion alif. Threaded cylindrical cages made of titanium, cortical allograft donor bone or synthetic bone. Markings on the trial spacer indicate the entry points of the locking screws in the anterior aspect of the adjacent verte. Lumbar interbody fusion surgery austin, tx disc herniated. Lumbar interbody fusion has become a standard technique in the modern spine. Anterior lumbar fusion alif the harley street hospital.
I have been fighting the pain for about 18 months and take pain medicine all the time. The current main techniques of posterior lumbar interbody fusion plif surgery all incorporate a supplementary intervertebral implant. A tlif fusion transforaminal interbody fusion is far less invasive. Lumbar interbody fusion what is lumbar interbody fusion. For example, a surgeon can access the spine through incisions in the lower back or through incisions in the front of the body. This approach requires a 46 incision in the center of the back to access one or two levels. Anterior lumbar interbody fusion springer for research. This manual of spine surgery has become necessary as a consequence of the rapid expansion of. One such procedure is anterior lumbar interbody fusion alif. A lateral retroperitoneal, transpsoas approach to the anterior disc space allows for complete discectomy, distraction, and interbody fusion without the need for an.
Anterior lumbar interbody fusion is a surgery to treat disc problems in the low back. In an anterior lumbar interbody fusion alif, the surgeon approaches the lower back from the front through an incision in the abdomen. This approach requires a 46 incision in the abdomen to access one or two levels. The procedure may be performed either as an open surgery or using minimally invasive techniques. The only additional risk of using the device in anterior lumbar fusion is that if the device is placed too far backwards or too far to the side it can damage a nerve root. A careful preoperative evaluation is critical, as most complications are approach related. The incidence of deep venous thrombosis following anterior spinal surgery ranges from 0 to 12. More recently pimenta popularized the lateral approach to interbody fusion, or extreme lateral interbody fusion xlif. An interbody fusion can be performed using a variety of different approaches. Spinal fusion has evolved dramatically ever since the first successful internal fixation by h adra in 1891 who used a posterior approach to wire adjacent cervical vertebrae in the treatment of fracture. Anterior lumbar interbody fusion alif, posterior lumbar interbody fusion plif, transforaminal lumbar interbody fusion tlif are offered by spine surgeons at pacific spine specialists in tualatin, portland in or.
Outcomes of anterior lumbar interbody fusion surgery based on indication. Anterior lumbar interbody fusion alif anterior lumbar interbody fusion alif is a spine surgery that involves approaching the spine from the front of the body to remove disc or bone material from in between two adjacent lumbar vertebrae. An alif is a spinal operation where the spine is approached from the front rather than from the back. Although it is associated with a lower risk of vascular injury compared with anterior midline approaches, neuromonitoring is considered mandatory to avoid neurologic complications. The anterior lumbar interbody fusion alif is similar to the posterior lumbar interbody fusion plif, except that in the alif, the disc space is fused by approaching the spine through the abdomen instead of through the lower back. Anterior lumbar interbody fusion med diagnostics rehab. A posterior lumbar interbody fusion plif is performed to remove a disc that is the source of back or leg pain and fuse spinal vertebrae with bone grafts. Outcomes of anterior lumbar interbody fusion surgery based.
Overview and indications anterior lumbar interbody fusion alif is a type of spinal fusion that utilizes an anterior approach to fuse the lumbar spine bones together. This article focuses on anterior lumbar interbody fusion and discusses only the surgical component of the procedure. Posterior lumbar interbody fusion plif portland back. The use of steinmann pin fixation in thoracic spinal instrumentation and fusion. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone. The patient group had revision surgery on average 17. Procedure 19 anterior thoracolumbar spinal fusion via open approach for idiopathic scoliosis.
An alif procedure is an operation in which the experienced spine surgeon enters from the front of the body. The five primary interbody fusion approaches are shown here schematically. The success of any spinal operation depends on good definition of the. To compare the clinical and radiological outcomes of alif for each surgical indication. Anterior lumbar interbody fusion alif back in control. Alif is a procedure used to treat problems such as disc degeneration, spine instability, and deformities in the curve of the spine. In the alif approach, a threeinch to fiveinch incision is made on the left side of the abdomen and the. Technique guide synfix lr stand alone spacer depuy synthes spine 11 notes.
What is an anterior lumbar interbody fusion alif procedure. Spinal fusion is a surgical procedure used to correct problems with the small bones in the spine vertebrae. The lateral lumbar interbody fusion llif is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the. Anterior lumbar interbody fusion alif video animation of surgery. The 4 th surgical procedure was an anterior lumbar interbody fusion alif. With this procedure, the anterior spine is accessed through an incision made in the front of the body, instead of through the back. A surgical approaches to the lumbar spine for interbody fusion techniques. Find this book in your library article information contributor notes.
Lumbar interbody fusion lif surgery is a surgical technique involving the removal of the damaged intervertebral disc, and the insertion of a bone graft into the. Anterior lumbar interbody fusion alif is performed to correct spinal problems in the lower back as an open surgery or minimally invasive technique generally used to treat back or leg pain caused by degenerative disc disease. A posterior lumbar interbody fusion, called a plif, is a surgery designed to stop the motion at the targeted segment of the spine. In this procedure, the surgeon works on the spine from the front anterior and removes a spinal disc in the lower lumbar spine. Through an incision in the front of the belly, the disc is removed. This textbook covers all the modern technical aspects of lif to keep it relevant for. From all the stories i read, people are still taking pain meds a year later. It is performed through the abdomen, usually with the assistance of a vascular surgeon to move the major blood vessels out of the way. Minimally invasive lumbar fusion is used to treat back. Anterior lumbar interbody fusion alif has become a widely recognized surgical technique for degenerative pathology of the lumbar spine. Lateral lumbar interbody fusion pubmed central pmc.
There is limited information on clinical outcomes after anterior lumbar interbody fusion alif based on the indications for surgery. In these clinical situations, the anterior lumbar interbody fusion may be supplemented with a posterior from the back instrumentation and fusion to provide additional support to the fused level of the spine. Technically, there is a wide variety of surgical procedures that can be performed to fuse the spine, including different cages or spacers hollow blocks to insert into the disc space with a bone graft. The plif is defined as posterior lumbar interbody fusion. Orthopedic spine surgeons at the harley street hospital are well trained for posterior lumbar interbody fusion surgery and have performed this advanced surgical procedure to help many patients relieve longterm chronic and acute low back pain. Interbody fusion means the intervertebral disc is removed and replaced with a bone or metal spacer using an anterior approach in this case. A complete discussion and description of the xlif technique was described. Anterior lumbar interbody fusion as a salvage technique for. Oblique lumbar interbody fusion during the last 20 years several lessinvasive anterior approaches to the lumbar spine have become standard, including the extreme lateral lumbar interbody fusion. Posterior lumbar interbody fusion overview youtube. Lateral approach for anterior lumbar interbody fusion xlif and dlif, ozgur, b. Most commonly it is performed on the l4l5 or l5s1 segment at the bottom of the lumbar spine. Authored by experienced surgeons and key innovators in the fastmoving field of lif surgery, lumbar interbody fusions provides an indepth, focused approach to recent advances in surgical techniques and technology.
Alif anterior lumbar interbody fusion is a spine fusion technique that is used to treat back or leg pain associated with a disc or spine condition. Lumbar interbody fusion has become a standard technique in the modern spine surgeons armamentarium. This is a rare complication and can be solved if the device is removed. It is called a posterior procedure because the spine is approached through an incision on the back. Currently one of the most frequently used spinal fusion techniques, alif is performed from the anterior of the spine through the abdomen. Severe lumbar low back or leg pain that is unresponsive to nonsurgical treatment. Instrumentation is used to provide space for placing the grafts and to help stabilize the. Covering both minimally invasive and open procedures, this comprehensive reference provides stepbystep details for proven techniques, including extreme lateral, oblique lateral. The anterior technique is often favored when multiple spinal levels are being fused and.
With a good access surgical team, the complications associated with alif are minimal extreme lateral interbody fusion is a relatively new procedure. Description of anterior lumbar interbody fusion surgery. The disc is removed and pressure on the nerves can be relieved. The lateral lumbar interbody fusion llif technique has shown encouraging results in patients with degenerative conditions of the lumbar spine 1,2. Anterior lumbar interbody fusion alif sydney lower. Anterior incision is chosen when the targeted area of the spine is closer to the front of the body or when. Anterior lumbar interbody fusion alif was first reported in 1906 and is currently an acceptable option for surgical treatment of spondylolisthesis. The transpsoas lateral lumbar interbody fusion llif technique was first introduced by pimenta and taylor in 2006 as an alternative to traditional anterior lumbar interbody fusion. These points are presented in this book as clearly as possible and are. Lumbar interbody fusions 9780323476638 us elsevier. The alif is defined as anterior lumbar interbody fusion. Anterior lumbar interbody fusion british association of. Predictors of the need for laminectomy after indirect. Anterior lumbar interbody fusion surgery houston, tx alif.
Injury to neural structures can result in femoral nerve palsy, 18 retrograde ejaculation, erectile dysfunction. Anterior lumbar interbody fusion alif surgical treatment. The surgery can be implemented either as an open surgery or minimally invasive technique. Predictors of the need for laminectomy after indirect decompression via initial anterior or lateral lumbar interbody fusion. The advantage of llif over traditional anterior approaches is that it avoids exposing the abdominal viscera, large vessels, and sympathetic plexus. In a lateral lumbar interbody fusion, the surgeon takes a side. Lumbar interbody fusion lif surgery is a surgical technique that involves the removal of a damaged intervertebral disc and the insertion of a bone graft into the disc space created between the two adjoining vertebrae. The surgical options for interbody fusion of the lumbar spine include. Anterior lumbar interbody fusion alif is a surgery performed to correct the spinal problems in the lower back. Anterior lumbar spine fusion alif is an advanced technique using minimally. Anterior lumbar interbody fusion alif is a surgical procedure performed to alleviate persistent lumbar pain, or pain in the lower region of the back. During preoperative consultation, all patients were informed of all surgical options including alif, posterior lumbar interbody fusion, transforaminal lumbar interbody fusion tlif, and xlif. Open anterior lumbar interbody fusion alif an introduction.
Fusion locks together two or more bones to stop painful motion and correct their alignment. Anterior lumbar interbody fusion alif is a surgical procedure that is performed to help relieve low back pain that may be caused due to degenerative disease of the intervertebral disc or a slippage of the vertebral bone. Fusion of the l5s1 segment in degenerative lumbar spine. This allows them to access the large bodies of the vertebrae with less disruption of back musculature. Access to the lumbar interbody space via a dorsal approach requires a detailed knowledge of the bony anatomy of the dorsal elements of the vertebral body. Transforaminal lumbar interbody fusion tlif was re.
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