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Anterior Lumbar Interbody Fusion with PPF
Anterior Lumbar Interbody Fusion with PPF

ALIF with PPF (Anterior Lumbar Interbody fusion with Percutaneous Pedicle screw Fixation)

This is a surgical procedure consisting of two steps, approaching the spine from the front and back to provide more solid stabilization and better outcome. First, the Anterior Lumbar Interbody fusion step is done. It involves approaching the spine through an incision (8 – 10 cm) in the lower abdomen where the degenerate disc is removed and metal prosthesis is securely fixed. The second step is the Pedicle screw fixation which provides additional support to the diseased level. Small incisions (less than 2cm) are done at the corresponding levels, where the screws and rod are safely secured. The surgery takes about 3 or 4 hours depending on the number of levels. The patient can ambulate the next day. Total hospital stay is for approximately three days. Patients will wear need a Lumbar brace while doing most of activities following the surgery for about 6 weeks. Physiotherapy starts 10 days after surgery, after the first follow up visit and wound check. The recovery is gradual from day one, at 1 month patient can return to full activity. The full fusion takes about 3 months.

You will need this treatment if,   

  • You are uncomfortable with standing or walking, but not feeling any symptoms when sitting.
  • You have difficulty in walking because of leg numbness/weakness.
  • Your pain is not improving after 6 weeks of conservative therapy including physical therapy, medical treatment and oriental therapy.
  • There is malalignment of your vertebra with instability (spondylolisthesis).
  • You are suffering from spinal stenosis, scoliosis, kyphosis or severe degenerative disc disease (DDD).

What is good about ALIF?

  • No blood transfusion
  • Less post-operative pain or after-effect
  • Short period of hospitalization
  • Faster recovery
  • No direct manipulation to nerves
  • Better fusion achievement
  • Better long term outcome

What should I expect after the surgery?

While in hospital

  • In most cases, you will be able to stand up after recovery from anaesthesia.
  • You will be able to go the washroom using lumbar brace and walker.
  • You will need the lumbar brace with activity.
  • A post-operative X-ray will be checked and reviewed.
  • You can take a shower, with caution regarding the wound area.
  • On third day after surgery you can go home with some pain medications.

Weeks 1-2:

  • You will be seen within 10 days after the surgery for follow-up, wound check and physiotherapy will be planned.
  • You will still need the Lumbar brace at all times except while sleeping.
  • Sitting will be allowed for not more than 30 minutes at a time.
  • It is important to ambulate frequently to speed your recovery. You are encouraged to walk, Climb up and down the stairs.
  • You can start doing some stretching at home.
  • In general you should avoid sudden movements special bending forward and twisting movements.
  • You can pray on the chair for now.
  • You must avoid lifting any heavy objects.
  • Always sit on proper chair with good lumbar support
  • Surgical site pain gets better every day. However you should report any signs of wound infection or any neurologic symptoms.
  • You may still need some pain medications.
  • You can drive for short distances after two weeks.
  • In case of any change in condition don’t hesitate to seek help through our numbers……

Week 6:

  • You will visit us again, and a new X-ray will be checked and reviewed. To assess the progress of fusion.
  • You can now sit for longer times, and be less dependent on Lumbar brace.
  • You should be able to return to work, you can now bend around the waist carefully.
  • We advise to continue with home exercises like walking about 30 minutes daily, along with the physiotherapy.

Three months:

  • We will see you again in the clinic, your spine should be fused now, and we will check your CT-Scan to ensure that.
  • Now you can pray normally without a chair.
  • Light to moderate intensity exercise is essential for spine health, we advise you to do brisk walking exercise at least three times a week.
  • You are now free to do all sorts of activities, however you should be cautious with repeated heavy work.
  • You are discharged from treatment.

The surgery aims at improving the quality of life, you should be alright when discharged from treatment. However, we may make an appointment to check your progress in a year’s time. If you would like to see us after discharge, please contact us.