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Best Alif Anterior Lumbar Interbody Fusion in Dhakuria

Anterior Interbody Fusion

Best Alif Anterior Lumbar Interbody Fusion in Dhakuria

Anterior Lumbar Interbody Fusion (ALIF) is a surgical procedure used to treat conditions such as degenerative disc disease, herniated discs, or instability of the lumbar spine. It is a type of spinal fusion performed to alleviate pain, restore spinal alignment, and promote long-term stability by fusing affected vertebrae into a single, solid bone. The surgery involves making an incision in the front of the abdomen, known as the anterior approach, which provides direct access to the spine. During the procedure, the damaged disc is removed, and a bone graft or fusion device is inserted into the empty disc space to restore the height of the intervertebral space and relieve nerve compression.

One of the key advantages of the anterior approach in ALIF is that it avoids cutting through the large muscles of the back, which is often required in traditional posterior methods. This reduces muscle damage, postoperative pain, and recovery time. Additionally, the anterior route offers direct access to the disc space, allowing for precise removal of disc material and optimal placement of the fusion device or bone graft, which helps maintain the alignment of the spine.

Following surgery, patients typically need to undergo a period of rehabilitation, which may include physical therapy. This rehabilitation process is designed to strengthen the core and back muscles and improve mobility, facilitating a smoother recovery. The ultimate goal of ALIF is to restore spinal alignment, alleviate pain, and ensure the fused vertebrae provide the necessary stability for a better quality of life.

FAQ's

Restoring the vertical space between two spinal vertebrae is the best technique to conceptualise ALIF surgery. The area where a lumbar disc nests between two vertebrae is weakened as it degenerates. A pinched nerve, instability, arthritis, or spinal deformity may result from this. Thus, radiculopathy (pinched nerve), degenerative disc disease, spondylosis (spinal arthritis), spondylolisthesis (instability), and abnormalities of the spine such as degenerative scoliosis can all be treated with ALIF.

The following might make you a candidate for ALIF surgery:

  • Degenerative disc disease
  • Spondylolisthesis
  • Scoliosis, or flat back syndrome
  • Symptoms that do not get better with medication or physical treatment

In order to be considered for ALIF, you must not have:

  • Conditions that might hinder the fusion of bones

  • Considerable previous abdominal surgery

  • Severe peripheral vascular disease

  • Obesity (a weight-loss plan is indicated)

  • Atherosclerosis of the aorta or iliac arteries

  • Significant loss of bone mineral density

ALIF surgery is performed by a vascular surgeon in conjunction with an orthopaedic or neurosurgeon. Specialised training in minimally invasive surgery is possessed by several spine surgeons. Inquire about the training of your surgeon, particularly if you have undergone prior spinal surgery or if your condition is complicated. With experienced and trained surgeons at Manipal Hospitals in Dhakuria, you can rest assured that you will get effective and personalised treatment.

Step 1: Getting the patient ready

Anaesthesia will be administered while you lie on the operation table. Your belly is cleaned and made ready for the procedure.

Step 2: Incision

The approach is planned using an image-guiding system or X-ray fluoroscopy. At the precise disc level, the vascular surgeon makes a 2–3-inch incision in your abdomen.

Step 3: Find the damaged disc

The retroperitoneal area and the abdominal cavity are gently made accessible by the vascular surgeon. The peritoneum sac, which is momentarily relocated to the right side of the abdomen, protects the intestines. The arteries and veins covering the injured disc or discs are carefully removed and set aside.

Step 4: Take out the disc

The injured disc is then removed by the spine surgeon. The number of damaged spine levels determines how many discs need to be removed. The disc space is opened by inserting a distractor device. The fusion bed is made ready using bone saws.

Step 5: Set up the disc space

After measuring the open disc space, a spacer size is chosen. The trial spacer is inserted into the gap on the disc. To make sure the depth, positioning, and wedge angle provide enough height and decompress the nerves, an X-ray is obtained.

The bone graft material is ready for fusion after a satisfactory fit is achieved. Bone-growing proteins are incorporated into the permanent bioplastic spacer cage using a mortar-like paste. 

Step 6: Inserting the bone graft

The permanent spacer graft is placed into the empty disc space under the guidance of X-ray fluoroscopy, pushing the two bones apart to restore normal disc height.

Step 7: Seal the wound

After the tools are taken out, the peritoneum returns to its normal size. Sutures hold the abdominal muscle closed. Dermabond skin adhesive is used to seal the skin incision.

The duration of an ALIF procedure varies greatly since it is mostly based on the unique anatomy of each patient. The entire process can take one to two hours for patients with an L5/S1 ALIF whose anatomy permits simple access to the front of the spine. The procedure may take significantly longer for individuals who have had previous operations, spinal abnormalities, or an architecture that makes it difficult to access the spine. The length of time needed for the procedure also increases if the patient needs to "flip" in order to insert posterior screws and rods.

Following one to three days of surgery, patients often return home for a one- to two-level ALIF with or without posterior fixation. They should talk to their surgeon about the details of their activities and recuperation. High-impact exercises like weightlifting, jogging, and sports (like golf) should usually be avoided by patients until the fusion between the vertebrae is more developed, which usually takes three to six months.

Crucially, the length of hospital stay may increase significantly if an ALIF is carried out in conjunction with a more extensive treatment (such as a Multilevel Anterior/Posterior Fusion or correction of a deformity). This increases the recuperation time's variability significantly as well.

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