Oct 12, 2022

Faridabad's First One-of-its-kind Minimally Invasive Spinal Fusion Surgery, ALIF, A game changer for spine deformity correction surgeries.

ALIF or Anterior Lumbar Interbody Fusion is a type of spinal fusion performed to stabilize a prolonged painful lower back, commonly caused by lumbar degenerative disc disease or spondylolisthesis.

Compared to conventional spinal fusion surgeries it benefits with lesser pain and a faster recovery. Allows better correction of spinal deformity or imbalance and has better long-term outcomes in terms of pain, quality of life, and reduced chance of developing problems in the spine.

First in Faridabad to conduct successful ALIF Surgery

A team of Spine Surgeons, Anaesthesiologists and Cardiovascular Surgeons came together to conduct a highly challenging and one-of-its-kind surgery - Anterior Lumbar Interbody Fusion (ALIF) along with Oblique Lateral Interbody Fusion (OLIF) on a 72-year-old woman suffering from Adjacent Segment Degeneration with Lumbar Canal Stenosis at L2-L3 & L5-S1 and Flat Back at Sarvodaya Hospital, Sec 8, Faridabad.

The Patient's Complications

A 72-year-old woman with a pre-operated spine was suffering from severe pain in the back and lower limb which impaired her ability to walk and sit. Her pain was unresponsive to any non-surgical treatment. She had been in the same condition for the last 6 months. But in the last 15 to 20 days the problem became worse.

The Successful Surgery

"When the patient visited us, on her initial investigation she was diagnosed with adjacent segment degeneration with lumbar canal stenosis at L2-L3 & L5-S1 with a flat back. Adjacent segment degeneration may have occurred after her spinal surgery that joined two or more bones together, stopping her natural motion. Along with this, she had lumbar canal stenosis which is a narrowing of the spinal canal in the lower part of the back that was causing serious symptoms and affecting day to day life. Also, the patient had a flat back due to which the lower spine lost some of its normal curvatures." said Dr. Ashish Tomar, Senior Consultant, Orthopaedics & Spine Surgery, Sarvodaya Hospital, Sector-8 Faridabad.

The doctors at Sarvodaya suggested ALIF L5-S1 and OLIF L2-3 with posterior spinal fixation and percutaneous pedicle screw fixation in 2nd stage, allowing her spine to be corrected with minimally invasive procedures and saving her from a major osteotomy of the spine which would have caused a great deal of blood loss during surgery and lot of pain post-surgery.

Role of a Cardiovascular Surgeon

"To conduct the ALIF surgery, the spine surgeons required access to the spine. This can only happen by mobilizing the abdominal organs and major cardiac blood vessels. Any mistake could lead to profuse blood loss. Once that exposure is provided, the spine surgeon can then remove all of the discs much more easily and place a much larger implant from the front." said Dr. Sumit Narang, Associate Director, Cardiothoracic & Vascular Surgery.

Excellent Support by Team Anaesthesia

Another challenge of this case was putting the patient in a stage of anaesthesia with a bounded restriction on drugs. The patient who was aged, and had comorbidities was supposed to be under the effect of anaesthesia, with all vitals maintained during the surgery. Any mishandling or incorrect judgement of the quantity of drugs could have led to complete paralysis. Such a process requires a highly skilled and experienced team of anesthesiologists. It's like fighting a Kargil War with all hands tied up. Thanks to the exceptional team of anesthesiologists, the patient came to her senses immediately after surgery.

This is the first-ever ALIF surgery in Faridabad. A two-day recovery from surgery resulted in the patient being able to walk without support, something that was deemed impossible a few days earlier.

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