L5/S1 anterior lumbar interbody fusion technique

Lumbar interbody fusion (LIF) is a procedure that is indicated for various spinal disorders including degenerative disc disease, instability and deformity, neoplasia, infection, and traumatic pathologies. Degenerative pathologies include discogenic lower back pain, radiculopathy due to foraminal stenosis, lumbar degenerative spinal deformity, and spondylolisthesis (1). There are various approaches to LIF: anterior (ALIF), posterior (PLIF), transforaminal (TLIF), oblique (OLIF) and lateral (LLIF). The LIF involves placement of an implant device following discectomy and endplate preparation (2,3). ALIF was first described in the treatment of Pott’s disease (4), and over time, ALIF procedure has been studied extensively and is now a commonly performed procedure for degenerative lumbar spinal disease (3,5). Unlike the PLIF technique, the anterior approach does not require access through the spinal canal with retraction of the nerve roots and cauda equina. Furthermore, it spares potential iatrogenic injury to the posterior spinal muscles (2).