Anterior lumbar interbody fusion (ALIF) - Step by step procedure details, anatomy, & recovery review
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- Опубликовано: 9 июн 2024
- **CLICK SHOW MORE FOR IMPORTANT ADDITIONAL DETAILS**
Hello friends, today I'm bringing you a video overview of the anterior lumbar interbody fusion or ALIF. This is a procedure to help take pressure of your nerves without having to go through the muscles of your back! We are able to make a small incision on your belly and insert all the hardware necessary to fuse two of your bones together if needed. The benefits of this procedure is leaving the muscles of the lower back uninterrupted which is perfect for patients who have had prior surgery or who have a lot of preoperative lower back pain. Learn more about it in the video above.
I'm a board certified orthopedic spine surgeon proudly serving the people of the Bradenton/Sarasota/Lakewood Ranch, FL area in a multi-specialty orthopedic group called 360 Orthopedics (www.360-orthopedics.com).
Timestamps:
00:00 - Intro
01:00 - Anatomy and Overview
06:06 - Surgical Procedure Steps
12:33 - Symptoms, Causes, Expected Recovery
20:21 - Conclusion
For A Consultation:
- Please call 360 Orthopedics at 941-360-2233 and ask for Dr. Armaghani
- Go to www.ArmaghaniSpine.com and click "Book An Appointment"
Office Locations - 360 Orthopedics
1. 5985 Silver Falls Run, Suite 101
Lakewood Ranch, FL, 34202
2. 2750 Bahia Vista St, Suite 100
Sarasota, FL, 34239
Other Related Videos:
Lumbar Stenosis - • Lumbar Spinal Stenosis...
Lumbar Spondylolisthesis - • Lumbar Spondylolisthes...
OLIF (Oblique Lumbar Interbody Fusion) - • OLIF (Oblique Lateral ...
TLIF (Transforaminal Lumbar Interbody Fusion) - • How I perform a TLIF (...
Websites:
www.ArmaghaniSpine.com
www.360-orthopedics.com/sheya...
Other Platforms:
Twitter: / armaghanispine
Facebook: / armaghanispine
The content on this RUclips video and channel, including, but not limited to, the text, graphics, images, links, and other materials are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice. Dr. Armaghani does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the website. Reliance on any information provided herein is solely at your own risk. The information provided on all websites associated with Dr. Armaghani, including www.ArmaghaniSpine.com, is designed to support, not replace, the relationship that exists between patient/site visitor and his/her physician. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this RUclips page or on www.ArmaghaniSpine.com. 
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I am having anterior and posterior lumbar fusion in a month for spondylolisthesis, central annular tear, moderate degenerative disc disease, para defect, and severe foraminal stenosis in L4-L5 and L5-S1!
I saved this video so I can watch it again and again to prepare me!
Thank you for making an awesome video!
*pars defect
Hello friend how you doing now??
I had this procedure done September 29,2022. Completely changed my life and I'm so grateful! God is so great!
Hi Snowboarding72, I'm scheduled for Feb 27 for mind. Question: Did you have a vascular surgeon assist in your surgery?
@@kcb3rdI have it on Jan 23rd... I have a vascular surgeon assisting my spine surgeon
@@kcb3rd I'm having it Feb 2. There will be a vascular surgeon.
I think you mean your surgeon is great.
@brianmacintire3064 hello friend how you doing now?
I’m scheduled to have this surgery done next month. Thank you for clearly explaining the procedure and especially the typical recovery process. You’ve set my mind at ease; I’ll be gracious to give my nerves the year they need to recover proper functioning.
Excellent! Easily the most comprehensive explanation of this procedure on RUclips.
I am obsessed with you videos, they are so educational and easy to understand. 10/10!!!! Please don't stop creating these gems.
Thank you, Amy!
@@ArmaghaniSpine is ALIF better than TLIF for runners?
Great job with the explanations of the ALIF process. Thank you.
I’ve had ALIF spinal surgery 12-2-2020… that was the 3rd spinal, the 1st & 2nd ones was botched. They put a spacer in with NO screws& it fell out & got tangled/twisted in my nerves.. 3yrs. after ALIF, I’m still in pain because of nerves. I’m only 46. I was 41 going on 42! I’m tired of crying and being in constant pain
U needed screws. I am sorry you went through that.
Hello Doctor! You are the most eloquent, responsive, and well dressed doctor I've seen. Thank for everything you do. I hope you can give an answer as you seem to understand and address all the nuances that others do not.
I'm 42 and I'm in exceptional physical condition. I'm 6 weeks post op from ALIF with ROI-A cage, screws and rods for a bulging L5-S1 disc into the posterolateral and foraminal space in the right side with a very very slight 2mm spondylolisthesis. I've never had any issues my entire life until sciatica 6 months ago that got severe. I was convinced it was piriformis syndrome because there was zero back pain even though I know the odds are that 95 percent of sciatica comes from discs and I had the MRI showing the severe foraminal narrowing. I went to 1 Ortho and 2 Neurosurgeons and all 3 said ALIF would be the way to go based off my images and symptoms. 1 of the Neurosurgeons is the head at PENN so I wasn't messing around. They all dismissed piriformis syndrome. I'm now 6 weeks post op and I'm recovering fast as fit people usually do, but my leg symptoms are still there. I'm well aware that the cage gave me a couple mm more of height so there could be some nerve stretch but it's nothing crazy because my disc height wasn't terrible in the first place like a patient with DDD. My concern is that the ALIF approach still leaves some disc material in the spaces I needed removed due to the approach from the front and inability to remove 100 percent of the disc. My doctor said that would dry up and absorb. Of course only an MRI would show the proper soft tissue imaging to see if the foraminal piece of the disc is still touching the nerve. I've never heard any doctor address that ALIF doesn't decompress nerves as well as TLIF because of the lack of access to the back of the disc so I'm guessing it's not a huge deal. Could there still be disc on my nerve? What if I give it a solid 6 months and the leg still feels the exact same? Should I then seek out an endoscopic piriformis decompression? I have such a great understanding of the anatomy and what is going on and I just want it solved. The leg doesn't feel like it did at its worst point but it still feels like it did leading up to surgery. I'm hoping it's just that the nerve needs to heal because if not, I will have given up a vital piece of my anatomy for nothing and all the future risks that come with that.
I'm about to have an ALIF and you were way more informative than my provider!!! THANK YOU for posting this!! I now understand exactly what I'm having done!
You are so welcome!
Hello friend how you doing now??
I am a retired physician about to undergo L4-S1 TLIF. I have been treating my osteoarthritis conservatively for 4+ years. In the past 6 weeks my low back pain has severely negatively affected my QOL. MRI shows marked progression with severe nerve root compression at more than one level with new anterolisthesis that is grade1. Your video presentation is awesome! Reenforced what my neurosurgeon said. I would highly recommend it for lay people.
Good luck, Dr. Wassum!
Awesome explanations, especially for patients that will be undergoing this surgery. Takes the unknown away. Thank you for the amazing visuals.
You are very welcome, Bill!
Thank you SO much for this wonderful video! I feel so much more confident about my procedure. I especially appreciate the detail you go into regarding by recovery. Knowing what to expect and the timelines for pain relief/recovery is incredibly helpful (and something not all doctors cover thoroughly enough). Thank you!!
You are so welcome!
Very helpful. My wife just had this procedure today so I was looking for a thorough explanation. You did great.
Excellent explanation. Very clear and complete.
This is phenomenal in its complete description and visuals for laypersons. Thank you for this gift of understanding from one gifted to heal with restorative medical skill. Be blessed.
I love your videos because they’re so easy to understand. I’m having neck & back surgery this year & your videos really help me understand what I will be going through. THANK YOU
You're most welcome.
Your videos are so informative and thorough! Thank you so much for sharing.
This was the best explanation of ALIF surgery or and procedure I ever watched. I’ll be having this surgery in a month and I feel more confident of what to expect pre and post surgery. Thank you
Getting ready for this surgery. Your explanation was outstanding. Very detailed and informative. Thank you
I’m 44 years old and had ALIF done 6 months ago. My early signs of spinal stenosis was, of course back pain, but what triggered my doctor into getting me an MRI was tingling in my feet. It felt like bugs were crawling on my ankles and feet, then it progressively turned into severe pain. Along with the back pain I started to get horrible stomach pain/ nausea.
After a few rounds of steroid injections ( which didn’t help) I was referred to a neurosurgeon. During the first five weeks post op I felt great. But, then the pain really intensified in my back, legs, and feet. My surgeon said this was normal as my spine is healing. He suggested that I walk several times a day, which did help. After 12 weeks post op I was finally able to go to physical therapy. They gave me great exercises to build back my core strength, then I was finally able to go back to work.
I still experience pain episodes from time to time but I realize that I’m not fully healed yet so I still limit my bending, lifting.
Unfortunately, I think I may have gotten a hernia in the last few weeks, which my surgeon said was possible because of the incision area. I have to let my doctor make that determination when I see him soon.
Your recovery process is very common. It is up and down for the first several months but how you feel at 1 year will be close to how you will feel long term.
I'm in the exact same position. I'm 6 weeks post op ALIF. I felt great for 4 weeks but the past 2 have been rough. Sciatica and some stiffness in my back is occurring. I'm also worried about a hernia going forward. What did you do to agitate your abs?
Probably the most informative, articulated, diagramed , and well produced medical video I have ever seen. You give Dr. Choll in California a run for his money. Wow. I have spondy of the L 5 S1 and 2 grade 3 Anterolistthesis on L5 S1. No leg issues but debilitating back spasms at times. Would love to see an O. R. video.
thank you for the kind words. Dr Kim in California has great videos
thank you for informative, precise and understandable description of the procedure that i wish my surgeon would have provided as my surgery is coming up.So, thank you again for sharing your knowledge and taking the time to do so
You're most welcome!
I am scheduled for an ALIF later this summer, and your video is by far the BEST explanation of this surgical procedure on RUclips. Thank you very much for sharing!
good luck! it's one of my favorite procedures and patients do great
How was your surgery
@ArmaghaniSpine, my husbands surgeon recommended, but he didn't mention vascular surgeon as part of the surgery team.
An amazing explanation! Thank you so much!
You are very welcome!
I'm about to have this procedure. Thanks for this video it makes me feel better . Thanks Doctor ❤️🙏
Wow so informative the best video I've seen. Thanks 4 posting. A surgery I will be having.
That was the best explanation I’ve heard.
Thank you, Elisabeth!
Thank you for your patient oriented explanation.
You are most welcome. It is your body and you must understand what we are doing.
Doctor thanks so much for the explantion.
Most welcome!
Thanks doc. I’m getting this next week. This was really helpful.
good luck!
Thank you! Clear presentation, Extremely helpful
Glad it was helpful!
Excelente explicação.
Amazing explanations! I’m having an ALIF next week and this made me feel way more informed and at ease.
Good luck!
How are you?Alif is ok?
Hi Steph I hope you are doing fine by now. I’m going to have mine in two months, I’m very curious and nervous. Can you tell me how’s was your surgery as well? Thank you
@@jazminjimenez1240 yes doing really well. Best decision I ever made, it’s rough at first but I’m 5 months out and have no pain at all.
@@stephhayward8455 I’m so happy to hear that!! Great!! Thank you for your response
I recently had this procedure done. I searched the internet for a month for a good video or even websites on this surgery. I didn’t find anything that great. This video is excellent!! 13 days post operative and it was still extremely informative to me. Gives me a better understanding of what happened and is happening. Thank you!
I also found out I have soft bone during the surgery. It does explain a lot about all the broken bones I have indured. Do you have videos on how to treat it. There’s a lot of information on osteoporosis but not so much soft bone.
hope you are continuing to do well!
Oh. My. God. Thankyou for this. I'm having a 2 day anterior/posterior spinal fusion but the first part is what freaks me out. Your description and chart alleviated my fear completely. I was so worried they were sifting through my abdomen and got all sleeved out. Not anymore ❤
You're fantastic at explaining this. Thankyou thankyou
Excellent video and Excellent information! Thanks very understandable
Glad it was helpful!
I’m getting this done 1 month from today. I’m pretty nervous about it but you laid it all out in an easy to understand way. Thank you so much. My doctor is great and I have a pre op appointment set to go over the procedure but it’s nice to be able visualize what’s going to happen.
You'll do great!
Gpaint, how did the fusion surgery go? Was it a success? Debating on mine, bc i have ddd and buldging disc.
How did it go? Hope all well well.
I have to get a posterior and anterior fusion done for spondolythesis and forminal stenosis! I’m nervous
This was so very easy to follow. Thanks so very much im a candidate for this procedure.
Thanks so much!
Thank you for u derstanding the procedure .as a medical coder it is very helpfull
i've had this done 11 years ago ALIF L4-L5-S1 My L4-L5 level isn't fused. So i actually rather choosed PLIF through the back. I'm not going to surgery anymore, it's really a major procedure on multiple levels. you also have to wear a corset for 3-6 months.
Excellent presentation. Thank you!
Glad it was helpful!
Excellent explanation. I had this procedure and my surgeon did not explain it as well as Dr. Armaghani did in this short video.
Great presentation
Amazing explanation!
Glad you think so!
Thank you
Very nice explanation. And easy and clear
please continue
Appreciate the words!
Having this surgery next week at Spine Institute in Shreveport, Louisiana, by Dr Utter. I pray it goes well. Your video helped me to understand and relax more about having the surgery.
Will be giving an update later on. Thank you for your video.
Good luck! It's a well known Institute, I'm sure you are in good hands.
Barbara, how did the surgery go? Im debating on it...
Very interesting. Thank you
Great explanation. Thanks
Glad it was helpful!
Glad I found this… Thank you
Welcome!
Just had this last week and it's so interesting to see how it was done. Great video. Thank You
Glad it was helpful!
@@jaybo516 Much better now but the 1st 3 weeks were rough.
Hello friend how you doing now??
I am getting prepared for spine surgery at the end of June 2022. Watching your video has helped me understand what will/ could happen. I’m not worried anymore. Thank you for the clarity and straightforwardness.
good luck!
How was your surgery? Hope all went well.
@@maxbelski it went well. I am even back to work earlier than expected.
@@boogie99025612 any suggestion on what nutrition we can have to help that area grow back faster? bone meal, collagen, wheatgerm .................. these kind of things maybe ?
Thanks very much for the video! May I ask which method is better Alif or Tlif?
I love how you explained the Alif procedure, so others can get a better understanding what to expect. Dr. you were very patience explaining the details.. on Dec 1 , 2021 I had to have one L4,L5,S1. I thank God for blessing them with knowledge and understanding the Wisdom . Do become great Doctors.❤️
Good luck!
Hello friend how you doing now?
Absolutely amazing , everything simplified. Except that shifting/pressing of internal organs in the stomach was pretty scary. You are indeed a great surgeon. Many thanks for the video.
You are very welcome!
Hi Doc, thanks for this excellent presentation. I am not sure if I missed it, but you didn't mention anything about autograft bone that you harvest from other areas compared to the TLIF approach. If I understand right you ony place the cage in the IVD space? Many thanks for your video once more :)
Good question, indeed. We do have to "bonegraft" when doing this approach meaning we have to put something inside the cage to help aid the bones on either side of the disk that we are fusing to send cells across the cage to form a solid fusion. People use a number of different manmade options which don't involve taking any bone from elsewhere in your body which decreases post-operative pain. These are called "allografts" as they come from a source that isn't you. Personally, i like to use bone morphogenic protein-2 or BMP-2 as it's called. This is an FDA approved allograft that improves fusion rates in ALIFs to greater than 90-95% and has been studied extensively over the last 20+ years to the point now that we are very precise in the amount that we put into the cages to maximize fusion rates but decrease any potential negatives which are very rare.
I think this is the complete knowledge. I wish we staying in a same place. Buy the way sir I'm also suffering from Early degenerative lumbar spondylosis disease so this incision procedure will go on with me?
Nice explanation 👍
Glad you liked it!
Wow Dr your explanations so good 👍 I am speechless
thank you!
Hi Dr i did my procedure last night it went well according the surgeons thanks again for your teaching 😂
Please do more of these. So informative. I had a decompression and fusion of L2 to S1 plus fusion. That was a year ago. In a lot of pain from the fusion. What can I do. Can a minimally invade correction be done ??
Thank you for your kind words. Visit your surgeon after surgery to ensure that you are fully fused. Not being fused is a common cause, in general, for long-term pain following surgery.
Super very well explained very clear beautiful voice super super I am suffering with this problem how will this cost thank u
Fantastic. I'm an IT guy (embedded, so close to the 'guts' of a computer), and I find this fascinating. Thank you.
thanks for the kind words
Thanks for this video, doc. I am having this procedure in less than two weeks and so afraid to do it. This helps so much.
hang in there!
Hello friend how you doing now?
I'm halfway through the video and it's a great explanation. My surgeon has recommended this surgery which I have to decide in the next month if I'm having it done. He recommended it because he doesn't have to cut through the back muscles, BUT, it seems much riskier than going through the back for the same procedure.
Comment please.
Thank you for these excellent videos. Your descriptions of anatomy are so helpful in understanding the sources of pain. I will soon have a L4-L5 laminectomy for central and foraminal stenosis and a fusion due to spondolithesis grade 2. Which of your videos might apply to this type of fusion to bring vertebrae into alignment? Your laminectomy video was excellent.
OLIF and TLIF will be the most common surgeries at L4/5. XLIF is basically an OLIF so the video applies. Good luck!
I really do appreciate the explanation of this surgery I’m having it done in the next 2-3weeks so tired of the pain but at the same time nervous about it but the pain got me kinda excited for the relief of pain ty
Had the procedure on 2/16/21 (not this doctor) but very pleased with the results so far
@@jamesgawne642 I pray you get everything out of getting it done (relief from pain) because that the part I’m looking ph so forward to but at same time this really my first time for major surgery and I’m 50 years old
Good luck, David. Just remember. It's a marathon not a sprint. You'll get the majority of your recovery within the first 12 weeks but full recovery isn't for 1 year. During that time period you will have ups and downs but don't get discouraged if that occurs. Ride the waves of the recovery and how you feel at 1 year will be how you feel long term.
@@ArmaghaniSpine thank you sir I will definitely remember that
Hey I just got mine done and at first I wasn’t in to much pain I think it was the narcos. But since Iv been home I haven’t taken any medicine I hope this pain is just from the surgery been about a week now. I have accidentally twisted does that effect the healing procedure if the twist isn’t like really that much of a twist if that makes sense? I didn’t have you as my doctor as well but more informative
Thanks Dr for this video. I had TLIF 4 months back I still have tingling in legs and muscles stretch in back. That put me down, I feel weak legs n numbness in foot fingers still. I am male 37 from india, still trying to find the way how to over come from all of this
Thank you so much I left hospital with dos or donts only when it came to pain meds
you're most welcome
I have an appointment next week. Hope you can help me with my situation.
Appreciate the video doc. What are your thoughts on hybrid procedures? I will be going in for a l4-l5 disc replacement and l5-s1 fusion.
Not a lot is published on hybrid procedures but I do, personally, believe that disk replacement is what we are going to be doing in the future much more than fusions.
Thank you!
You're welcome!
Thank you I'm having this done in 3wks very very scared cause I had a surgery similar to this about 4yrs ago which should have been done this way and wasn't and the new dr said the reason I'm still in so much cause I'm never healed from my surgery 4yrs ago so in 3wks he will be performing this surgery very scared of the pain the first time I stayed in lots of pain for about the first year and I'm scared it's going to be the same way. Will I be in constant pain after this surgery for a long time don't get me wrong I really trust this dr and he really let me feel safe and understandable I'm just afraid of the pain!!!!!!!!!
Thank you ❤️
You’re welcome 😊
Thank you so much for taking the time to create such an informed video. I am a 22 year old female with Spondylolisthesis Grade 2 L5S1 with a pars defect in which the disc is worn down all the way. I was told I need fusion surgery. However, one surgeon said he would do an ALIF anterior/posterior and another said he would do ALIF anterior only. I understand that anterior only is less invasive and would provide a quicker recovery but there could be an issue in regards to the screws not being as strong as well as it possibly taking longer for the bone to grow because there's not as much as stability as if you secure it with bigger screws from the back. I would really value any opinion you can give me. Thank you so much!
That is a fantastic question. I can speak in generalities about spondylolisthesis with pars defects. Placing a cage between the L5 and S1 bones is the main treatment but some people like to go through the front (ALIF) and others like to go through the back (TLIF). Those who choose ALIF can just put the cage there and others like to place the cage through the front but additional screws in the back. Think of the screws in the back as a "belt and suspenders" approach to keep L5 and S1 still so you can heal the fusion through the cage. From my understanding, there isn't a lot of great evidence for one being much better than the other. In general, in my practice, patients with a spondylolisthesis at L5/S1 always get screws in the back in addition to the ALIF cage but that is because I'm a little more conservative than most.
@@ArmaghaniSpine Dr. Thank you so much for the video and explanation. I am much comfortable about the sugary.
I am 45 female, was a professional volleyball player. I had same condition as that 22 years of patient. L5S1 chronically pars defect with Grade 1 spondylilosthesis.
The Dr. also suggested ALIF plus put screws at the back to stabilized the spine. May I ask would those surgeries complete at the same time? Are those surgeries all minimally invasive surgery. Thanks for your time!
Is the disc completely removed during this procedure ? What happens if the disc is herniated generating central stenosis ? Should the compressing elements be removed , or the removal of the disc elements will render thos elements loose and non compressive ? I always wondered about this detail.
Hello Dr., I have a question I’m having this surgery done December 6, and I was wondering would I be ok having this surgery with a hiatal hernia? Thanks
How does the range of motion looks like after a fusion at the S1L5 level? What things I wouldn't be able to do anymore?
Can you have this procedure on your L4-L5 if you have had a C-section?
❤AWESOME DR. WISH I COULD BE HIS PATIENT!!
This guy good I have spinal stenosis operation soon. Going to NYC hospital special surgery
top notch place. good luck!
Thanks for your demonstration, I have an question about the approach of ALIF？Which side is better？Right or left？The image you showed is right· Thank you．. Rex
Great Question, Rex. While that is the right side of the screen, for purposes of orientation, it is as if you are looking at yourself laying down from the feet up. With that orientation it is actually the left side of the body. At L5/S1 (the lowest segment) you can actually go on either side although most people go on the left side. At levels above it is almost exclusively left side. Thank you for the feedback and hope that cleared things up!
Having this procedure done March 2024, learn alot of information
How did you make out?
Thanks.
Welcome!
Thank you for this informative video. I just found out I will have this procedure on my L5-S1 June 1st in Houston at Methodist hospital. I had a foraminotomy a few years ago and it didn't last long. I'm ready for relief my feet go to sleep when I stand more than a few minutes.
Good luck! ALIF is a great procedure especially following prior spine surgery.
Prayer for your recovery 🙏🏾🙏🏾🙏🏾🙏🏾🙏🏾
How did the fusion surgery go? Success and pain? I am debating the identical surgery.
Thank you so much for your explanation of this surgery.
I’m 41 male and had L4-S1 ALIF surgery on dec 18th 2024, I’m about 13 weeks out and doing relatively well recovering but having so flare ups and bad days depending on on how my day went. I’m in physical therapy and I am seeing progress after each session, but the exercises are strenuous, even though they are easy exercises to perform. My body has become deconditioned. My chief complaint is the fatigue I face day to day, I feel as if it prevents me from achieving even the easiest of tasks sometimes. Sometimes after a walk, errands, PT, light chores I feel as if I ran a marathon. Does anyone else experience this sort of problem who’s has some sort of spinal surgery? Will this feeling go away? I am feel someone down mentally about this. It’s hard to stay focused on essential daily tasks when I feel so tired day to day.
Hi Armaghani, what’s the difference between an orthopedic surgeon and Neurologist surgeon for this type of surgery? I need to do one and I talked to a neurologist friend and he recommended it was better to do it with a neurosurgeon
Dr Armaghani I had this procedure last November 2021 and when I came out of surgery my diaphragm was paralyzed and part of my lung was collapsed. Have you ever heard of this. I had to have plication surgery on my diaphragm to get it off my lower lung.
I just has a 2 level lumbar spinal fusion from L3 to L5. My surgeon had trouble placing the cage from a TLIF at L4/L5. I still have significant foramina stenosis at that level and I am wondering if an ALIF would be the best follow up. Is placement of the cage guaranteed with ALIF or might he still not be able to get a cage placed? Or would a better follow up be a decompression?.
Im about to jave this surgery but i jave many areas that need surgery, is it normal for them to suggest 1 surgery at a time
Dr. Armaghani, thank you so much! I am so grateful that I was one of the select patients ALIF was appropriate for. After my fusion, my wife and I are able to fornicate without me experiencing pain.
(the bad kind, that is)
I couldn't recommend you enough!
Thank you so much for your kind words Mr. Knutz!
Thank you very much for your excellent video, I have a question about the fusion procedure, do we lose mobility and/or flexibility with the fusion? I need an L4-L5-S1 ALIF surgery
With an L4-S1 fusion you will notice some loss of range of motion particularly in twisting and bending side to side. Just at L5/S1 or just at L4/5 you wouldn't really notice a difference.
I had this done along with Posterior. Fortunately, no major complications.
Great to hear you are doing well!
Hello friend how you doing now??
Hello Doctor! Thank you very much for this video. I'm 12 days post-op ALIF L3/L4 surgery. I had it done because of the DDD and back pain located mainly in back muscles. I didn't have any nerve issues before the surgery, only local pain in lower back. I still feel my old, well-known pain from before the surgery. My surgeon told me that I shouldn't worry about it and it will subside. Could you comment on it somehow? Is it normal to have the same back pain at this point in my recovery process? Best regards!
In general, I tell my patients that for the first month or 2 they will "hate me" because of the pain in their back due to the stretch of the ligaments from putting the cage in. There are good days and bad days during this time. The further they get out from surgery the more good days they will have than bad but full recovery isn't for 9-12 months. So i generally counsel patients that how they feel at 9-12 months will be how they feel long term so it is definitely more of a marathon than a sprint. good luck!
How’s your back doin at around 7 months out? What did your back pain feel like before surgery?
Hello and thank you for the video doctor. Just curious if you can access the nerves from going through the front?
great question. you can partially yes but it isn't something we (or I rather) routinely do. if im doing surgery through the front I am banking on the increase in the space between the bones to be enough to take the pressure off the nerves. About 10-15% of the time it doesn't quite do it enough to the patient's liking and in those situations we go back 6 months later for a small, minimally invasive, outpatient bone removal from the back to make sure nothing is touching the nerve anymore.
@@ArmaghaniSpine thank you so much for the reply. I had a discectomy/laminectomy 8 months ago. Had extremes of back and nerve pain. Over a course of 7 months, I finally got rid of the nerve pain my limiting my movement and diet. Back pain always stuck with me(couldn’t bend). My bottom disc ruptured since then, but never got relief from surgery. My bottom disc is beat up even though I’m 38/male. Got very bad inflammation/ back pain that seems to stem from the bottom disc. The rest of my spine seems to feel unstable since the surgery. Just curious if an alif would be beneficial? I currently haven’t had a quality of life in a year and a half. Your responses are greatly appreciated so thank you again.
Great video. If you have a successful fusion is there a chance you could have continued pain or worse pain than before surgery?
Great question, Alex. As a conservative estimate, most people will get about 65% improvement within the first few months of surgery in the discomfort that goes down their leg. There is incremental improvement after that for some patients but that has to do with how much the nerve is able to repair itself. Some ppl get 95+% recovery. Others dont get better than the 65%. It is difficult to know who those patients will be though. How you feel at 1 year, will generally be how you will feel long term though and pain that is still around after 1 year is likely permanent due to damage to the nerve from being compressed prior to surgery. As for back pain, it is very variable in how much recovery people get. Sometimes it's a lot. Sometimes not much at all. That is why patients who have more extremity symptoms than back pain tend to do much better overall and have the highest patient satisfaction following surgery. Hope that helps!
@@ArmaghaniSpine thank you, that’s great. I have discogenic L5-S1 for 8 years with no leg symptoms at the moment. 2 injections with mild relief. An Alif has been recommend and my lumbar spine is straight. Is it really important to restore lordosis at my age 29 years old?
Pozdrav ja sam kandidat za ovu vrstu operacije ali zbog viska kilograma koje sam dobio zbog usporenog rada stitnjace odgodena mi je koliko se kg mora imati da se moze napraviti operacija i ako mi mozete reci nesto o komplikacijama i kakva je to operacija
doctor i have a L4 L5 S1 i just got my new i had 3 MRI but this one says L5 S1 broad posterior disc hernation which is slightly more prominent than on the prior study deforms the ventral epidural space and there is left greater than the right foraminal extension with abutment of exiting left L5 root and narrowing of the foramina diminished disc space height ventral extension of the disc remains and discogenic chages and scmorl;s node in the end platates.mild facet hypertrophic changes remain L4L5 S1 ,,,,,doc my friend told me narrowing part of stenosis ,doctor can you help me out with this ,,thank i been watching ur video;s there very good ,,thank you,,ps my doc can be fixed with endoscopic laser surgery,doc what do you think,
0:43 Dr. Armaghani, do you perform lateral/oblique LIF?
Thanks for this great video. I am having ALIF on March 9th at Penn Spine. They are going to go through my low back on the sides as you mentioned in video. Can you explain why they would want to do that as well as the ALIF?
My guess is they could be doing multiple levels but also sometimes the approach is easier from one side or the other based on your anatomy. Good luck!
@@ArmaghaniSpine thanks. These are the procedures
Arthrodesis ALIF
Arthrodesis/posterior /posteriolateral technique
Thanks again
In your video state state No bending/twisting/lifting over 20 lbs. So, are you saying that it's ok to do those things without any weight right away? I understand that if so, it needs to be moderate...
Just had this done 5 days ago
Hope you are well!
Can you do one on a 360 fusion? I have spondylolisthesis, neural foraminal stenosis, ddd, severely impinged nerve roots, arthritis. Im 28 and I have a three year old so im waiting 1 more year until she is in preschool.