Anterior Lumbar Interbody Fusion (ALIF)
◦ approach
usually done through trans-retroperitoneal approach
◦ decompression
decompression of nerve root done indirectly by foraminal distraction via restoration of disc height
◦ fusion
grafts used include autologous iliac crest, structural allograft, and cages of various materials
◦ pros
may increase chance of union by more complete discectomy and endplate preparation
allows improved restoration of disc height
◦ cons
retrograde ejaculation and sexual dysfunction
persistent radiculopathy due to inadequate indirect foraminal decompression
persistent low back pain may be caused by nociceptive pain fibers in pars defect that are not removed in an anterior procedure alone