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Procedure

Anterior Lumbar Fusion (ALIF)

    What Is Anterior Lumbar Interbody Fusion Surgery?

    Anterior lumbar interbody fusion (ALIF) is a spine surgery procedure to treat disc problems in your lower back. The first ALIF surgery was performed in the 1950s to treat symptoms of lumbar degenerative disc disease. Top spinal surgeons carry out this spinal procedure using an anterior or frontal approach. From this point of access, a skilled spine specialist removes the damaged spinal disc and places a cage or a spacer bone graft in the gap created.

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    Removing a damaged disc eases pressure on the surrounding nerves, which delivers much needed pain relief to your back and spine. Using a metal plate and screws, the doctor fastens the spacer to your spinal bones, reducing movement but adding spinal stability. The graft between the two vertebrae bones promotes fusion, so your bones grow together in the space.

    Today, spinal specialists use advanced methods to improve the efficiency of the procedure and to ensure better results. To determine if ALIF surgery is the right procedure for you, consult a board certified spinal doctor. The neurosurgery and spine experts at Premier Brain & Spine, with seven locations in New Jersey and one in New York use the latest medical technology to treat a wide range of spinal conditions.

    What Are the Advantages of Anterior Lumbar Interbody Fusion?

    Spinal doctors use different techniques to treat lumbar disc problems, but ALIF surgery has unique advantages.

    Some of the benefits of ALIF spinal surgery include:

    • Less pain, with minimal disruption of your back muscles
    • A faster recovery than posterior spinal fusion
    • A better chance of successful fusion with the larger spacer graft used
    • More effective spinal surgery with better access
    • Reduced risk of damage to spinal nerves

    Despite the larger graft, the risk of structural nerve damage is lower. The anterior approach makes the surgery easier. During your consultation, your spine physician explains the procedure to you in detail, and you may ask questions until you fully understand it.

    What Conditions Does ALIF Surgery Treat?

    If you have nagging pain in your lower back, you most likely have a lumbar disc problem. The cushioning effect of your spinal discs provides you the flexibility to bend, twist and turn. Any structural changes that damage these intervertebral discs may cause debilitating pain and other symptoms.

    Anterior spinal fusion is one of the most effective treatments for lumbar spine disc problems, such as:

    ALIF is an advanced spinal procedure that helps alleviate symptoms such as numbness in your legs, overall weakness, tingling and other problems associated with spinal disc damage. If you have persistent lower back problems, visit an advanced spine surgery center like Premier Brain & Spine, with offices in NJ. These specialists use a multi-faceted approach to spinal treatments for the best outcomes.

    Am I a Good Candidate for Spinal Fusion?

    While ALIF surgery is highly successful in treating lower spine problems, it’s not for everyone. During your initial consultation, your spine physician examines your spine and carries out extensive tests to determine whether you’re a good candidate for the procedure. Some conditions that make you a good candidate for spinal fusion include:

    • Shooting pain in your lower back
    • Pain in your buttocks, thigh and calf
    • Numbness or tingling in your lower extremities
    • Stabbing or localized pain
    • Radiating pain or radiculopathy
    • Immobility and stiffness
    • An excessive amount of spinal instability
    • Slippage of your vertebrae
    • A fractured vertebra

    The spinal doctors at any of the NJ spine surgery centers have the expertise and technology to correctly diagnose your lumbar spine problem. After the assessment, your doctor discusses the viability of anterior spinal fusion. An individualized approach to treatment is one of the reasons these doctors have a successful track record.

    Who’s Not a Good Candidate for Anterior Lumbar Interbody Fusion?

    Your doctor may rule you out as a candidate for spinal fusion based on your diagnosis.

    Some factors that make you a bad candidate for ALIF include:

    • Multiple failed lumbar fusion surgeries
    • Multiple abdominal surgeries
    • Aortoiliac occlusive disease
    • Peripheral vascular disease
    • Extreme vertebral instability
    • Severe osteoporosis
    • Severe compression fractures
    • Osteoarthritis
    • Being severely overweight

    If you experience lumbar back pain, don’t wait for it to get worse. Any back pain may signal a serious underlying issue. If your spine doctor determines ALIF isn’t the best procedure for you, an alternative that addresses your specific condition and symptoms will likely be available.

    How Is the ALIF Surgery Procedure Done?

    Your spinal surgeon performs the ALIF surgery while you’re under general anesthesia. The surgery takes one to two hours.

    The main steps in this spinal fusion procedure include:

    1. You lie supine, on your back, before the procedure starts.
    2. General anesthesia is administered to put you to sleep for the procedure.
    3. The surgical team cleans and prepares your abdominal for surgery.
    4. Your spinal surgeon plans the anterior approach using x-ray fluoroscopy.
    5. The physician makes small incisions on your belly at specific spinal disc levels
    6. Your surgeon creates a pathway in your abdominal cavity to locate the damaged disc.
    7. The spinal surgeon removes the damaged disc or more. A distractor instrument fits into the gap left.
    8. The doctor measures the open disc space and makes a custom spacer.
    9. Using fluoroscopy, your surgeon carefully inserts the permanent spacer graft into the empty disc space.
    10. A plate and screws are added to provide added stability.
    11. Finally, the doctor closes the incision with sutures.
    12. The doctor monitors your heart rate, blood pressure and respiration while you rest in a recovery room.
    13. You may be able to leave the same day as your surgery, but you may need a day or two under observation.

    Before surgery, organize to have someone to drive you home when you’re discharged. Follow your doctor’s post-surgery care to promote healing.

    What Are My Post-Surgery Steps after ALIF Surgery?

    To promote recovery, avoid complications and get the best results, top doctors at your NJ spine surgery center provide post-surgery care guidelines that include:

    • Follow the incision care instructions
    • Avoid smoking as this affects prevents bone growth
    • Don’t drink alcohol as it increases the risk of bleeding
    • Avoid excessive back movements, such as bending and twisting
    • Don’t drive until you’re given your doctor’s approval
    • Avoid heavy lifting
    • Avoid strenuous activities
    • Attend the follow-up appointments with your doctor
    • Take only the prescribed pain medications

    Patients with structural instability of the spine or a lumbar herniated disc can return to regular activities of daily living with help of anterior lumbar interbody fusion, often abbreviated ALIF. To learn more about the anterior lumbar interbody fusion procedure or to schedule an appointment with a spine doctor, call (866) 590-0601. Feel free to visit our neurosurgery center to find out why so many of our patients consider us to be the best surgeons in New York and New Jersey for treating disc problems in the low back with cutting-edge spinal fusion surgery.

    Updated on Jun 2, 2025 by Dr. David Wells-Roth (Neurosurgeon) of Premier Brain & Spine

    Premier Brain & Spine
    10 Parsonage Rd, Suite 208A
    Edison, NJ 08837
    (732) 258-0190