Conditions for Minimally Invasive ALIF
Mini ALIF is commonly used for these conditions:
Patients with spondylolisthesis have one bone in their back (vertebra) that has moved forward over the bone below it in the spinal column. We sometimes call this spinal instability, and it can be very painful. Spondylolisthesis usually happens at one of the lowest two levels in the spine, L4/5 or L5/S1. Spondylolisthesis may be accompanied by spinal stenosis (narrowing of the spinal canal). This narrowing of the spinal canal can pinch the nerves. The most common symptoms are pain in the lower back, along with pain, weakness and/or numbness into the legs (called sciatica or radiculopathy.
UW Health spine surgeons perform several different types of surgery for spondylolisthesis, depending on the patient’s specific anatomy and their symptoms. Options include:
- MIS TLIF (minimally invasive transforaminal lumbar interbody fusion)
- Lateral fusion (XLIF, DLIF or OLIF)
- Minimally invasive anterior lumbar interbody fusion (Mini ALIF)
Increasingly, our surgeons are using the Mini ALIF because of the overall effectiveness and relatively rapid recovery.
Degenerative Disc Disease
The normal disc serves as the cushion between the bones of the spine and allows for spinal motion while maintaining stability. Every adult experiences age-related changes in their discs as they grow older, much like we all get wrinkles and most of us get gray hair. The disc loses some of its elasticity, becomes less flexible and shrinks in height. These age-related changes are often called degenerative changes, and in most people, do not cause problems. However, sometimes the degenerative changes are painful or are associated with narrowing of the spinal canal (spinal stenosis), and under these circumstances may be referred to as degenerative disc disease.
Most cases of painful degenerative disc disease, with or without spinal stenosis, can be treated non-operatively with physical therapy, anti-inflammatory medications such as ibuprofen, physical therapy, or spinal injections. Some patients continue to have pain, in which cases surgery may be appropriate.
Surgery for degenerative disc disease is usually performed when it is accompanied by spinal stenosis (narrowing of the spinal canal). When the spinal stenosis is the main problem, a decompressive surgery without a fusion, such as a lumbar laminectomy, may be performed to take the pressure off the nerves, but this does not address the degenerative disc disease. When degenerative disc disease is thought to be a large part of the problem, a fusion may be performed. While the fusion may be performed with a variety of techniques, all of which our surgeons perform, our surgeons are increasingly using the Mini ALIF because of the overall effectiveness and relatively rapid recovery.
Ongoing Pain After a Lumbar Discectomy
Surgery to remove a herniated lumbar disc is one of the most common spine surgeries performed, and most patients make a full recovery and return to full activities without restrictions. There are many professional athletes and weekend warriors competing at a high level after a discectomy.
Some patients have ongoing pain, or the pain comes back after a pain-free interval. This can be due to another disc herniation, or it can be due to degenerative disc disease. Sometimes the symptoms can be treated non-operatively with physical therapy, anti-inflammatory medications such as ibuprofen, physical therapy or spinal injections. When significant pain relief does not result, surgery may be appropriate.
Surgery for ongoing pain after a lumbar discectomy may consist of a revision discectomy alone or may include a fusion operation. When a fusion is thought to be appropriate, our surgeons are increasingly using the Mini ALIF because of the overall effectiveness and relatively rapid recovery.