In general, lower back surgery requires an open surgery with large incisions and extensive muscle involvement. It is also necessary to remove part of the bone in order to reach the intervertebral disc which is located in the front of the spine. This method will injure and scar the muscles which lead to longer recovery time and the prospect that pre-surgical muscle condition cannot be restored.
With such problem, ALIF or anterior lumbar interbody fusion, an alternative method has been introduced to treat patients with degenerative disc disease, spinal deformities, and spinal tumors. ALIF treatment does not require metal supports, in case of degenerative disc disease, as the insert already comes with screws that can readily be attached to the bone. It has a wide cross-sectional area to fully support the weight of the bone. It can support 80% of the body weight which is close to natural bone.
The Advantages of ALIF
Its benefits include:
- No need for additional metal
- Can support more weight
- Can be used in all lower spine area, especially the bottom (L5, S1- pelvic bone) which cannot be treated by DLIF (Direct Lateral Interbody Fusion) without damaging the back muscles. Plus, DLIF has limitations because the hip bone obstructs surgery from the side.
- Bone morphogenic proteins (BMPs) can be used to speed up bone healing. BMPs cannot be used in posterior surgery because it will cause narrowing of the spine, where nerves run through.
In fact, ALIF or anterior surgery was developed before DLIF which is a surgery from side of the body. However, the procedure is not common because it requires highly skilled surgeons. A vascular surgeon experienced in posterior back surgery is required because the surgical site is near the main blood vessels and nerves. Bangkok International Hospital recommends ALIF procedure with a team of surgeons who are specialized in orthopedics, neurology, as well as the vasculature among others, to provide integrative and effective patient care.
ALIF surgery is quite successful as the incisions do not cut through muscles because it goes in through the abdomen. Although lots of blood vessels are involved, but the experienced team of surgeons can smoothly move them out of the way. The benefit of this technology is that the device comes with built-in screw, so there is no need for additional support. In medical term, it is called Stand Alone ALIF, which can successfully resolve the patient’s pathologies and the rate of rigid fusion is better than the old method.
Post-surgical Care
The patients can go back to their normal routine within 1-2 weeks and achieve bone fusion within 3 months. ALIF technique is suitable for spinal disc surgery, abnormal spine or even tumor removal without disturbing spinal nerves. The incision is about 3-4 inches long without damaging any muscle. In the future, ALIF is the answer to the limitations of advanced surgeries such as those that involve the diaphragm and chest cavity. Surgery can be done because a team of vascular surgeon will join the team of orthopedic surgeon to provide rapid and effective treatment. Each patient will have carefully designed protocol to suit individual condition based on the right technique at the time of surgery as well as overall cost-effective treatment plan to make the experience less frightful to the patients and their family.