| Spinal Fusion | | | | ALIF should only be considered following the patient's |
| Spinal fusion for the management of lumbar | | | | unsuccessful completion of an organized nonoperative |
| degenerative disc disease has been available for | | | | rehabilitation program. Aids to diagnosis in the case of |
| several decades. The results of this procedure remain | | | | a patient with mechanical low-back pain expand upon |
| under constant scrutiny and progressive development. | | | | a thorough history and physical examination. |
| Anterior lumbar fusion was initially introduced in the | | | | Radiographic studies; plain films, bone scan (SPECT), |
| early 1920s. Fibula and iliac struts, femoral rings and | | | | CT scan, MRI and discography, all play a role in patient |
| dowel, as well as synthetic metallic devices have been | | | | evaluation. Frequently more than one of these |
| applied as fixation implements to aid in lumbar interbody | | | | diagnostic studies is needed for an accurate diagnosis. |
| fusion. Approaches to the spine have experienced | | | | ALIF may be utilized as an isolated procedure or in |
| similar evolutionary changes. Prior to the 1950s most | | | | conjunction with posterior spinal fusion. The method |
| anterior lumbar approaches were extensive | | | | with which ALIF is accomplished depends largely on |
| transperitoneal exposures (i.e. through the membrane | | | | the surgeon's preference and experience. Minimally |
| lining the walls of the abdominal and pelvic cavities). In | | | | invasive techniques - open or laparoscopic - require |
| 1957, Southwick and Robinson introduced the | | | | greater intraoperative attention to detail and |
| retroperitoneal approach (i.e., behind the peritoneum). | | | | preoperative surgical planning. |
| Transperitoneal exposures (i.e., through the peritoneum) | | | | Indications for ALIF Degenerative Disc Disease |
| require incision of both the anterior and posterior | | | | The suspected lumbar level requires confirmation as a |
| peritoneum. In contrast, retroperitoneal expoures | | | | pain generator by diagnostic testing. Multilevel disease, |
| maintain the integrity of the peritoneum and approach | | | | i.e., greater than two levels of the spine, is less |
| the spinal column laterally behind the bowel and | | | | predictable and therefore rarely indicated for ALIF. We |
| peritoneal contents. This has the advantage of less | | | | have found that single-level disease in a psychologically |
| post-operative bowel problems. Additional changes in | | | | stable patient, responds well to ALIF |
| technique have seen the advent of minimally invasive | | | | Please log on to :- |
| approaches, including endoscopic and laparoscopic | | | | Please log on to :- |
| methods. Minimally invasive approaches are generally | | | | We Care Core Values |
| directed at one or two-level disease processes. | | | | "We have a very simple business model that keeps |
| Anterior lumbar interbody fusion (ALIF) may be useful | | | | you as the centre." |
| in the treatment of unyielding low-back pain. The cause | | | | Having the industry's most elaborate and exclusive |
| of this pain is often difficult to diagnose. Broad | | | | Patient Care and Clinical Coordination teams stationed |
| categories of pathology that may be associated with | | | | at each partner hospital, we provide you the |
| persistent low-back pain include degenerative disc | | | | smoothest and seamless care ever imagined. With a |
| disease, spondylolysis, spondylolisthesis or iatrogenic | | | | ratio of one Patient Care Manager to five patients our |
| segmental instability. | | | | patient care standards are unmatched across the sub |
| | | | continent. |
| Perhaps a candidate for a ALIF procedure | | | | |