Fusion process is held to join the bones with the help of the bone graft, adding either bone graft substitute or even directly bone graft. It is done in the spine and biological response is set up. So, the bone starts growing in between the vertebral elements and the motion at that particular segment can be stopped. Anterior lumbar fusion is needed to perform for the instability experienced with the spine, fracture or degenerative disc disease. It is performed at the low back reason. The objective of this procedure is to provide the stability to the spine. And result is that the deformity or pain will reduced. Anterior lumbar fusion can be performed in multiple methods. Anterior Lumbar Interbody Fusion or ALIF is one of the methods. The advantage of ALIF, when compared to the posterior LIF, it does not disturb the nerves and muscles at the back. There is also another advantage that graft placed at the front of the spine can better place the compression and compression of the bone gives better fusing.
Before the surgery starts, it is important for the patient to quit smoking, otherwise
ALIF is performed with a procedure in steps.
- Surgical Approach
The procedure starts with an incision of 3 to 5 inches made over the left part of the abdomen and sometimes alternatively done in the midline. Then the muscles in the abdomen are retraced to one side. The contents present in the abdomen are laid in a big sack and it is also retracted, so that the surgeon is allowed to access front part of the spine easily. The large blood vessels that pass towards the legs are also retracted off gently from the anterior spine. Such practice and procedure can be well performed by vascular or general surgeon.
- Removal of Disc
Initially, a needle is to be inserted into the disc space and the accurate level of the spine, x-ray is done. Once the right disc space is identified using the x-ray, then the removal of disc is done. Dissection is done at this point from front towards back of the disc.
- Fusion Bed Preparation
Once the disc is removed, there will be some space left in between the bodies of vertebral. The width, height and depth of the bone graft is then template by either spacers or disc space shavers. If any irregularities are present in the bone graft, these are meticulously prepared at the vertebral body surfaces. It helps the ingrowth of the bone at the surface.
- Bone Graft and Fusion
The bone graft, which is cancellous bone graft is usually taken from the pelvis. Alternatively or sometimes additionally, extenders and bone graft substitutes can also be used. lordosis and the disc height is maintained by a weight bearing and structural component is needed, as the disc spaces of the lumbar are taller. Then the combination of non-structural and structural component is to be inserted in the disc space. ALIF procedure is performed in this way with minimal incision or one small incision and sometimes is also preferred to be done with endoscope. The results of both these procedures are the same. However, the choice of the approach is based on various factors.
After the surgery is performed successfully, it is important that the patient restricts the motion. The limited motion of the spine can improve and faster the formation of the bone. So, it is important to avoid lifting, bending and twisting. This precaution must be continued for at least three months, post spinal fusion surgery.
- Bleeding uncontrolled
- Injuries to blood vessels, intestines, stomach or kidneys
- Breathing problem
- Gas that was used for the expansion of the abdomen may cause the pain in chest or should and may continue for one to two days
- Damage may happen to the nerves, blood vessels, spine, muscles, bone and ligaments
- Weakness developing
Cost of Minimally Invasive Anterior Lumbar Interbody Fusion in India
The above Package Cost is a tentative Approximate Package Estimate for Anterior Lumbar Interbody Fusion in India, which includes initial investigations & specialists screening, stay in a Private Room wherein patient’s assistant or relative can also stay with patient, doctor / surgeon fee, nursing care, medicines & consumables, Airport Pick-Up & Drop.
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