Anterior Lumbar Interbody Fusion (ALIF): A Patient Guide to Lumbar Spine Surgery

Lower back pain that radiates into the legs can significantly limit your ability to work, exercise, and enjoy daily life. When conservative treatments fail to provide lasting relief, your spine specialist may recommend Anterior Lumbar Interbody Fusion (ALIF). This guide explains what ALIF is, why it is performed, how the surgery works, and what to expect during recovery.

What Is Anterior Lumbar Interbody Fusion (ALIF)?

Anterior Lumbar Interbody Fusion (ALIF) is a surgical procedure used to treat conditions affecting the lower (lumbar) spine.

• Anterior means the surgeon approaches the spine from the front of the body, through the abdomen.

• Lumbar refers to the lower back.

• Interbody fusion involves removing a damaged disc and fusing the two adjacent vertebrae together using a spacer (cage) and bone graft.

The goal of ALIF is to relieve nerve pain, restore spinal stability, and correct alignment by eliminating painful motion between vertebrae.

Why Is ALIF Recommended?

ALIF may be recommended for patients with lumbar spine conditions such as:

• Degenerative disc disease

• Spondylolisthesis

• Disc collapse or discogenic back pain

• Foraminal stenosis

• Failed prior back surgery

• Spinal instability

• Chronic low back pain with or without leg pain

ALIF is often chosen because the anterior approach allows for excellent disc space access, placement of a large implant, and restoration of normal spinal height and alignment.

Symptoms ALIF May Help Relieve

• Chronic low back pain

• Pain radiating into the hips or legs

• Numbness or tingling in the legs

• Weakness or fatigue with standing or walking

• Pain worsened by sitting, bending, or lifting

Many patients experience significant improvement in both back pain and leg symptoms following surgery.

How the ALIF Procedure Is Performed

1. Anesthesia

ALIF is performed under general anesthesia.

2. Anterior Abdominal Approach

A small incision is made in the lower abdomen. The surgeon carefully moves aside abdominal muscles and blood vessels to safely access the spine without cutting through the back muscles.

3. Disc Removal

The damaged disc is completely removed, relieving pressure on surrounding nerves.

4. Implant Placement

A spacer (interbody cage) filled with bone graft material is placed into the disc space. This restores disc height, improves alignment, and promotes bone fusion.

5. Stabilization

In some cases, additional screws or rods—placed either anteriorly or posteriorly—may be used to improve stability and fusion success.

Benefits of ALIF Surgery

• Avoids cutting back muscles

• Restores disc height and spinal alignment

• Indirect decompression of nerves

• High fusion success rates

• Improved posture and spinal balance

• Reduced back and leg pain

• Faster recovery compared to some posterior approaches

Because the spine is accessed from the front, ALIF allows for placement of larger implants, which can enhance stability and fusion.

Recovery After ALIF

Hospital Stay

Most patients stay in the hospital 1–3 days, depending on overall health and number of levels treated.

Pain and Activity

• Incisional soreness is common initially

• Walking is encouraged early

• Bending, lifting, and twisting are restricted during early healing

Return to Work

• Desk or light work: 3–6 weeks

• Physical or labor-intensive work: 4-6 months

Fusion Timeline

Bone fusion typically develops over 3–6 months, with continued strengthening for up to a year.

Physical therapy may be recommended to improve strength and mobility once healing is underway.

Risks and Potential Complications

ALIF is generally safe, but as with any surgery, potential risks include:

• Infection

• Bleeding

• Blood vessel injury (rare, minimized with experienced surgical teams)

• Nerve injury

• Failure of fusion (nonunion)

• Persistent pain

• Need for additional surgery

Your surgeon will carefully evaluate your anatomy and medical history to minimize these risks.

Who Is a Good Candidate for ALIF?

You may be a good candidate if:

• Conservative treatments have failed

• Imaging confirms disc degeneration or instability

• You have mechanical back pain with or without leg pain

• You require restoration of disc height or alignment

• You are healthy enough for surgery

Not all patients are candidates for ALIF; your spine specialist will determine the most appropriate approach for your condition.

ALIF vs. Other Lumbar Fusion Techniques

ALIF is one of several lumbar fusion options. Others include posterior or lateral approaches. Each technique has advantages depending on the diagnosis, spinal anatomy, and surgical goals. Your surgeon will recommend the approach that offers the best balance of safety, stability, and outcomes for you.

Final Thoughts

Anterior Lumbar Interbody Fusion (ALIF) is an effective, well-established surgical option for treating chronic low back pain and spinal instability when non-surgical treatments are no longer effective. With careful patient selection and modern surgical techniques, ALIF can significantly reduce pain, restore function, and improve quality of life.

If you are experiencing persistent lower back pain or leg symptoms, a consultation with a spine specialist like Dr. Remi Aijboye can help determine whether ALIF is the right treatment option for you.

Remi M. Ajiboye M.D. is considered one of the best board-certified spine surgeons in Los Angeles who is trained in non-surgical and surgical management of spine conditions. He has advanced training in minimally-invasive spine surgery and complex spinal reconstruction. Dr Remi Ajiboye serves Torrance, El Segundo, Long Beach, and the surrounding communities of South Bay, Manhattan Beach, Hermosa Beach, Redondo Beach, Rancho Palos Verdes, Rolling Hills, Lomita, San Pedro, Carson, Lawndale, Gardena, Hawthorne, Santa Monica, Marina Del Rey, Culver City, Inglewood, Ladera Heights, South Gate, Lynwood, Compton, Los Alamitos, Westminster, Garden Grove, Lakewood, Cerritos, Bellflower, Downey, Paramount, Bellflower, Norwalk, Whittier, Santa Fe Springs, Anaheim, Santa Ana, Orange, Tustin, Fullerton, Seal Beach, Huntington Beach, Newport Beach, and greater Los Angeles county and Orange County. Contact Remi Ajiboye, MD, online or over the phone to set up an appointment.

Author

Remi Ajiboye MD Remi M. Ajiboye M.D. is a spine specialist who is trained in non-surgical and surgical management of spine conditions. He has advanced training in minimally-invasive spine surgery and complex spinal reconstruction.