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Anterior Lumbar Interbody Fusion (ALIF)

What is ALIF surgery?

ALIF, or anterior lumbar interbody fusion, is an approach to spinal fusion surgery in which the neurosurgeon accesses and repairs the lower (lumbar) spine from the front (anterior) of the patient’s body. This is usually accomplished through a lower abdominal incision.

illustration of the alif, olif, and llif approaches to the spine
Illustration showing the ALIF, OLIF, and LLIF approaches to the spine.

Spinal fusion is performed to join or grow together two or more bones in the spine, called vertebrae, eliminating movement between them. This is done by removing the intervertebral disc between the two vertebrae, which normally enables the spine to bend and rotate, and inserting a bone graft in its place. The bone graft heals over several months, fusing the vertebrae together and stabilizing the spine. When the abnormal motion at the disc is eliminated, back pain from the damaged disc can be controlled. 

The anterior approach allows the surgeon to directly access the spine without cutting through muscle tissue in the patient’s back. The neurosurgeon makes an incision in the abdomen and moves blood vessels and organs aside to reach the spine. This approach can be performed as an open surgery or a less invasive surgery, depending on the patient’s condition and medical history.

One benefit of going through the stomach is the ability to put a larger cage in the disc to provide better support and to increase the size of the space between vertebrae.

Additionally, ALIF procedures can be done with or without placing screws in the spine. Most famously, Tiger Woods received the stand-alone ALIF without pedicle screws and rods. This version of the procedure limits the damage to healthy tissue and maximizes the range of motion in the join after surgery.

If you have a tall disc height and little arthritis, you may be a candidate for the placement of a true artificial lumbar disc.

What is ALIF surgery used for?

ALIF surgery can be used to treat the following conditions of the lumbar spine:

Am I a good candidate for ALIF spinal fusion surgery?

You may be a good candidate for ALIF if you are experiencing any or all of the following:

  • Severe back pain that is not responding to conservative measures such as physical therapy and epidural steroid injections
  • Instability
  • Weakness
  • Pain caused by one of the previously listed conditions and have already tried nonsurgical treatments

Spinal fusion changes the normal movement of the spine, which may accelerate wear and tear of the vertebral joints above and below the fused vertebrae.

If you do need ALIF, your neurosurgeon can help determine which approach is best for you.

Medically Reviewed by Randall W. Porter, MD on March 31, 2022