The purpose of an ALIF/PSF is to fuse the segment in the lumbar spine that is causing pain with movement, if those segments are indeed degenerative. The idea behind the fusion is that stopping movement at that segment will no longer cause pain. Prior to surgery, proving that pain is coming from a specific level is usually confirmed with injections.
An ALIF/PSF (CPT code: 22558) is usually done for the last 2 levels in the lumbar spine, L4-5 or L5-S1. A vascular surgeon does the exposure for Dr. Brusovanik and accessing the spine from the front of the abdomen just below the navel. Once the spine is exposed the disc is removed and an interbody with bone graft is placed in the disc space. The incision is then cleaned and closed using a plastic surgery technique. Over the next few months, bone grows in the disc space connecting the two vertebrae causing a fusion.
The patient is then turned onto his/her stomach; small incisions are made in the back where the screws are passed through the muscle planes. This technique prevents muscle injury. Screws are inserted into both sides of each vertebrae (above and below) the disc space being fused. Rods are then placed on each side to connect the screws, stopping any movement at the painful level.
Patients are encouraged to walk the same night of surgery and are kept in the hospital for 1-2 nights. Patients are able to perform their daily activities once they are discharged home. They are able to go back to work within 1-2 weeks. Patients with labor intensive work can return in 3-4 weeks.