ALIF Procedure

Anterior Lumbar Interbody Fusion, or ALIF, is a surgical procedure where the spine is accessed anteriorly while patients are lying supine, on their back. This technique allows a direct view of the disc space and vertebral bodies. ALIF requires a small incision on the abdomen, usually to the left of the belly button, where a set of stable retractor blades are inserted down to the level of the spine. These retractors protect the abdominal organs while the intervertebral disc is replaced by an anterior interbody device and bone graft material. The back and lateral muscles are spared in the ALIF which can reduce postoperative pain.

LLIF Procedure

Lateral Lumbar Interbody Fusion, or LLIF, is an anterior column approach to spinal fusion in which the surgeon accesses and repairs the low back with an approach from the side of the patient, as opposed to an approach from the back or the front. During the procedure, the patient is positioned laterally, the surgeon uses a pathway to the spine through the psoas muscle which is located behind the abdominal contents and connects to the lower back to the thighs. This minimally invasive procedure is designed to spare the muscles, tendons, ligaments, and other tissue from the major disruption associated with traditional open back surgery. The LLIF procedure often involves the use of a tubular retractor to hold the muscles open and provides the surgeon a clear view of the spine for replacement of the intervertebral disc with the lateral intervertebral device and bone graft.

OLIF Procedure

Oblique Lumbar Interbody Fusion, or OLIF, is a variation of lateral access surgery in which the surgeon accesses and repairs the low back from the front and side of the body. OLIF is also referred to as “anterior to the psoas” surgery because the spine is accessed in front of the psoas muscle. This allows for a less-invasive approach, since there is no trauma to the psoas muscle – the muscle that connects the lower back to the thighs. With OLIF there is also no need to mobilize the major vasculature as in the ALIF procedure.

For this technique, the patient is positioned laterally, and the surgeon accesses the spine through a small incision in the abdomen in front of the hip bone. Specialized tools are used to access the spine between the affected vertebrae. The surgeon then removes any damaged or diseased disc material and inserts a bone graft or spacer between the vertebrae to promote fusion.

PLIF Procedure

Posterior Lumbar Interbody Fusion, or PLIF, is a surgical procedure where the spine is approached by making an incision in the middle of the lower back. The spine is accessed posteriorly for replacement of the intervertebral disc with the posterior intervertebral device and bone graft.

TLIF Procedure

Transforaminal Lumbar Interbody Fusion, or TLIF is a variation on the PLIF approach. The disc space is still accessed posteriorly but slightly more from the side compared to a PLIF to reduce the movement of nerve roots to access the space. Once the disc space has been accessed, the procedure for removal of the intervertebral disc and placement of the posterior intervertebral device and bone graph uses the same instrumentation as the PLIF.