ALIF: ANTERIOR LUMBAR INTERBODY FUSION SURGERY
OVERVIEW
ALIF (Anterior Lumbar Interbody Fusion) is a procedure that treats spinal injuries and diseases by approaching the spine from the front of the body to remove the damaged disc or bone. This procedure can be performed as traditional, open surgery, or with minimally invasive techniques. The benefit of accessing the spine from the front instead of the back is that back muscles and nerves are not disturbed.
ANATOMY
The spine consists of 33 individual bones (known as vertebrae) that interlock. The vertebrae are categorized into five regions:
- Cervical
- Thoracic
- Lumbar
- Sacrum
- Coccyx

The primary function of the vertebrae in the lumbar region of the spine is to bear the weight of the body. To support that weight, lumbar vertebrae are larger compared to the other vertebrae.
Intervertebral discs sit between the vertebrae. They are the shock absorbers for the spine. They are flat, round, and about half an inch thick. They are made of two components — the nucleus pulposus and the annulus fibrosus. The nucleus has a jelly-like consistency and can be found in the center of the disc. The “jelly” allows the disc to be flexible and strong. The annulus is the flexible outer ring of the disc and consists of several layers. When moving or standing, weight is put on the nucleus, causing it to expand while the annulus holds it in place. Together, the nucleus and annulus allow for movement to take place while simultaneously maintaining the strength of the spine. Many nerve endings surround the annulus, and as a result, an injured annulus can cause pain.

DESCRIPTION
Anterior Lumbar Interbody Fusion (ALIF) is a spine surgery that approaches the spine from the front of the body to remove disc or bone material from between two adjacent lumbar vertebrae. The procedure may be performed either as an open surgery or using minimally invasive techniques.
In contrast to a posterior approach to low back surgery, when your surgeon uses an anterior approach, they can access your spine without moving the nerves or muscles. Organs and blood vessels must be moved to the side with an anterior approach.
There are several reasons why someone would need to undergo an ALIF, such as:
- One or more broken vertebrae
- Spondylolisthesis (slippage of one vertebra over another)
- Protruding or degenerated discs (the cushiony cartilage between the vertebrae)
- Instability of the spine (abnormal or excessive motion between two or more vertebrae)
- People with low back or leg pain due to degenerative disc disease

For the most part, any spinal instability that has not responded to non-surgical treatments are potential candidates for this procedure. But ALIF as a stand-alone technique is usually not recommended for people whose bones have become very soft due to osteoporosis, or in patients with instability or arthritis.
There are many factors your physician will consider in determining if this procedure is right for you. These include your age, health, lifestyle, and anticipated level of activity following the surgery.
SURGICAL PROCEDURE
During the procedure, an incision is made in the abdomen, and the organs and major blood vessels are moved, allowing your surgeon to have a clear view and easy access to the front of the spine. Once your surgeon can access the spine, the degenerated disc is removed from the affected disc space, followed by the insertion of either bone graft or a suitable substitute into the disc space between the vertebrae.
The graft material acts as a binding medium and helps maintain standard disc height. As the body heals, the vertebral bone and bone graft eventually grow together and stabilize the spine. Instrumentation, such as rods, screws, plates, cages, hooks, and wire, also may be used to create an “internal cast” to support the vertebral structure during the healing process.
Once the procedure is finished, all the organs and blood vessels are returned to their original positions, and the incision is closed.
Surgeons typically perform an ALIF as a traditional, open procedure as described above. But another option is to access the spine using minimally invasive (endoscopic) technologies. They allow surgeons to reach the affected vertebrae through small incisions and intramuscular tunnels created to accommodate special guidance, illumination, and surgical tools.
NEXT STEPS
Contact your Florida Orthopaedic Institute physician to learn more about ALIF: Anterior Lumbar Interbody Fusion.
Areas of Focus
- Spine
- ALIF: Anterior Lumbar Interbody Fusion Surgery
- Artificial Disc Replacement (ADR)
- Back Surgery Types
- Degenerative Disc Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discitis
- Epidural Injections for Spinal Pain
- Kyphosis
- Minimally Invasive Spine Surgery
- Outpatient Spine Surgery
- Pinched Nerve
- Sciatica
- Scoliosis
- Spinal Fusion
- Spondylolisthesis and Spondylolysis
- Vertebroplasty
- Whiplash and Whiplash Associated Disorder (WAD)
The following Florida Orthopaedic Institute physicians specialize in ALIF: Anterior Lumbar Interbody Fusion Surgery:
Specialties
- Achilles Tendinitis - Achilles Insertional Calcific Tendinopathy (ACIT)
- Achilles Tendon Rupture
- Achilles Tendonitis
- ACL Injuries
- ALIF: Anterior Lumbar Interbody Fusion Surgery
- Ankle Fracture Surgery
- Ankle Fractures (Broken Ankle)
- Ankle Fusion
- Arthritis & Adult Reconstruction Surgery
- Arthroscopic Chondroplasty
- Arthroscopic Debridement of the Elbow
- Arthroscopic Rotator Cuff Repair
- Artificial Disc Replacement (ADR)
- Aspiration of the Olecranon Bursa
- Avascular Necrosis (Osteonecrosis)
- Back Surgery Types
- Bankart Repair
- Basal Joint Surgery
- Bicep Tendon Tear
- Bicep Tenodesis
- Bioinductive Implant
- Broken Collarbone
- Bunions
- Bursitis of the Shoulder (Subacromial Bursitis)
- Calcific Tendinitis of the Shoulder
- Carpal Tunnel Syndrome
- CARTIVA® Implant For Big Toe Joint Arthritis
- Charcot Joint
- Chiropractic
- Colles’ Fractures (Broken Wrist)
- Community Outreach
- ConforMIS Knee Replacement
- Cubital Tunnel Syndrome
- De Quervain's Tenosynovitis
- Degenerative Disc Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discitis
- Dislocated Shoulder
- Dupuytren’s Disease
- Elbow
- Elbow Bursitis
- Elbow Injuries in Throwing Athletes
- Epidural Injections for Spinal Pain
- Finger Dislocation
- Flexor Tendonitis
- Foot, Ankle & Lower Leg
- Fractures Of The Shoulder Blade (Scapula)
- Fractures Of The Tibial Spine
- Functional Nerve Transfers of The Hand
- Ganglion Cysts
- General Orthopedics
- Glenoid Labrum Tear
- Golfer's Elbow
- Growth Plate Injuries Of The Elbow
- Hallux Rigidus - Cheilectomy
- Hand & Finger Replantation
- Hand & Upper Extremity
- Hand & Wrist
- Hand Nerve Decompression
- Hand Skin Grafts
- Hip & Thigh
- Hip Arthroscopy
- Hip Dislocation
- Hip Flexor Strains
- Hip Fractures
- Hip Hemiarthroplasty
- Hip Muscle Strains
- Hyperextension Injury of the Elbow
- Iliotibial Band Syndrome
- Interventional Pain Management
- Interventional Spine
- Intraarticular Calcaneal Fracture
- Knee & Leg
- Kyphosis
- Labral Tears Of The Hip (Acetabular Labrum Tears)
- Lateral Collateral Ligament (LCL) Injuries
- Lisfranc Injuries
- LITTLE LEAGUER'S ELBOW (MEDIAL APOPHYSITIS)
- MACI
- MAKO Knee Replacement Surgery
- MAKO Total Hip Replacement
- Mallet, Hammer & Claw Toes
- Medial Collateral Ligament Injuries
- Meniscus Tears
- Metatarsalgia
- Minimally Invasive Spine Surgery
- Morton’s Neuroma
- Muscle Spasms
- NAVIO Surgical System
- Nerve Pain
- Neuromas (Foot)
- Olecranon Stress Fractures
- Orthopaedic Total Wellness
- Orthopedic Trauma
- Osteoarthritis of the Hip
- Osteoporosis
- Outpatient Spine Surgery
- Partial Knee Replacement
- Patellar Fracture
- Pelvic Ring Fractures
- Peripheral Nerve Surgery (Hand) Revision
- Pinched Nerve
- Plantar Fasciitis
- Podiatrist or Orthopaedic Physician?
- Primary Care Orthopedics Sports Medicine
- PROstep™ Minimally Invasive Surgery for Bunions
- Quadriceps Tendon Tear
- Revascularization of the Hand
- Reverse Total Shoulder Replacement
- Revision Knee Surgery
- Rheumatoid Arthritis (RA) of the Shoulder
- Rheumatoid Arthritis Of The Hand
- Robotics
- ROSA® Knee Robotic Surgical Assistant
- Sciatica
- Scoliosis
- Senior Strong
- Shin Splints
- Shoulder
- Shoulder Arthritis
- Shoulder Arthroscopy
- Shoulder Replacement
- Shoulder Socket Fracture (Glenoid Fracture)
- SLAP Tears & Repairs
- Spinal Fusion
- Spine
- Spondylolisthesis and Spondylolysis
- Sports Hernias (Athletic Pubalgia)
- Sports Medicine
- Sprained Ankle
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Tennis Elbow
- Thigh Fractures
- Thigh Muscle Strains
- Total Ankle Replacement
- Total Hip Arthroplasty
- Total Hip Replacement - Anterior Approach
- Total Knee Replacement
- Triceps Tendonitis
- Trigger Finger
- UCL (Ulnar Collateral Ligament) Injuries
- Ulnar Neuritis
- Valgus Extension Overload
- Verilast
- Vertebroplasty
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Whiplash and Whiplash Associated Disorder (WAD)
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Sprains
- Wrist Tendonitis