Causes and Treatments for Failed Anterior Lumbar Interbody Fusion
Most forms of spinal fusion are “posterior,” which means they are performed by accessing the spine from the patient’s back. Over 80% of spine surgeons prefer some type of posterior approach to lumbar spinal fusion. Unfortunately, these types of fusions have a high failure rate, indicating that some type of chronic or severe pain comes back after surgery.
At Spine Center Atlanta, Dr. Chappuis – a nationally renowned expert in both spinal fusion and failed spine surgery – has strongly supported the use of ALIF, or “anterior lumbar interbody fusion.” The ALIF approach accesses the spine from the patient’s abdomen, and has been shown to have a significantly lower risk of failure, and a much more promising reduction of pain.
But all spine surgery carries risks. Surgical failure can occur even with a successful ALIF procedure, and patients that find that they are struggling with any type of pain after back surgery may have suffered from failed anterior lumbar interbody fusion.
What is “Failed ALIF”?
Failed ALIF is a term that surgeons use to indicate that a patient has experienced pain despite undergoing the ALIF procedure. It encompasses any and all types of pain, provided the pain is not associated with the normal discomforts of healing.
As a result, “failed ALIF” may refer to any number of different issues, including:
- Poor Patient Selection
- Incomplete Decompression
- Failed Fusion/Pseudoarthrosis
- Foramen Narrowing
- Adjacent Segment Disease
- Surgical Error
- Arachnoiditis, and More
Pain may also be similar to the pain felt before surgery including the back, buttocks, and legs, or it may be a new and different type of pain. All of these fall under the umbrella term of Failed ALIF.
Why Does ALIF Fail?
ALIF is one of the more successful spinal fusion options available. It is considered more difficult, which is why surgeon selection is important – many spine surgeons only perform posterior spinal fusion because they find the surgery to be easier, despite its worse outcomes. But in general, the risk of failed ALIF is low.
However, the spinal cord is very sensitive, and both the discs and the spinal column are fragile. Mistakes or issues with healing may occur. Similarly, patient selection is very important. Patients that are obese may not be candidates for ALIF, and some surgeons may misidentify the cause of the pain, leading to a surgery that may not be the right choice for the patient’s particular pain.
It is difficult to identify the reason for failed ALIF surgery without a complete and thorough diagnosis, but surgeons with expertise specifically in failed back surgery, such as Dr. Chappuis and his team at Spine Center Atlanta, can often pinpoint the exact issue that led to the recurrence of chronic pain, and then potentially recommend effective treatment options for pain reduction.
Failed ALIF Treatment
If a patient is experiencing pain, the first step is an accurate diagnosis to note any potential structural issues that may have resulted in that pain. If no structural issues are found, it is recommended that you first try a more conservative, non-surgical approach to see if the issue can be reduced with treatments such as physical therapy, medications, and counseling. Treatments that failed previously may be successful at treating any new causes of pain.
If a structural issue is found, revision spine surgery may be recommended. It is important that this surgery is performed by those with expertise in failed back surgery, as the treatment for failed ALIF requires a very knowledgeable and skilled hand. This is one of the reasons that Spine Center Atlanta has become a popular source for people from across the U.S., as patients seek the expertise of Dr. Chappuis and Dr. Julio Petilon and the rest of the Spine Center Atlanta surgical team.
If you’ve had an ALIF and believe it may be failing and are interested in finding out more about how to treat the new or returning pain, please call us today at 404-351-5812 to get started. We offer no cost MRI reviews to anyone with a recent MRI and eVisits (telemedicine) consultations with our surgeons for those who would rather see a surgeon online before traveling to our facility. Ask for more details when you call.