Watch Dr. Sarraj explain
After your surgery
Your postoperative protocol
Dr. Sarraj’s instructions for activity, medicines, wound care and follow-up. Your hospital discharge instructions and individual care plan take priority.
Lumbar fusion
The shared protocol for ALIF, LLIF and posterior lumbar fusion.
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What the operation involves
ALIF reaches the lower spine through an incision in the lower abdomen. The abdominal contents and nearby blood vessels are carefully moved aside. The affected disc is removed and replaced with a spacer, also called a cage, containing bone graft. The graft helps the vertebrae grow together over time.
The aim may be to restore disc height or alignment, improve stability and create more space for nerves. Some operations also need screws through the back or a separate decompression to free the nerves. Your surgeon will explain which parts are planned for you.
Why this approach may be chosen
The front approach provides access to the disc without going through the back muscles for that part of the operation. Your diagnosis, spinal levels, blood-vessel anatomy and previous abdominal surgery help determine whether ALIF is suitable. It is one option alongside fusion from the back or side, decompression alone and nonsurgical care.
Abdominal soreness and swelling
Soreness, bruising and mild swelling around the incision are expected early on. Left-sided abdominal discomfort and local swelling can occur when the approach is from the left. These symptoms should gradually settle.
An abdomen that becomes increasingly swollen or tight, severe or increasing pain, or repeated vomiting needs urgent assessment. Do not assume these changes are ordinary postoperative soreness.
Eating and bowel recovery
Bowel function may be slower after abdominal surgery, anaesthesia and opioid pain medicine. Follow the hospital instructions about restarting food and drink and using constipation medicines. Begin short, frequent walks as soon as it is safe, including on the day of surgery when possible.
Contact your care team if constipation is not improving with the prescribed plan. Inability to pass gas together with abdominal pain or swelling, repeated vomiting, or inability to keep fluids down needs urgent assessment. These symptoms can reflect a bowel problem such as ileus, when the bowel temporarily stops moving normally.
Activity and healing
ALIF uses the same lumbar fusion postoperative protocol as LLIF and posterior lumbar fusion. Download it above for the activity table, medicines, wound care and follow-up schedule. Keep walking regularly during the first six weeks and increase distance gradually.
Temporary nerve irritation can cause tingling, sharp shooting pains or “zingers,” or a flare of leg pain. These symptoms often settle as the nerves recover. New or worsening weakness, or the warning signs below, needs assessment.
Follow the wound instructions you received in hospital. Sutures may need to be removed at the two-week follow-up.
Risks to discuss
In addition to infection, blood clots, nerve injury, implant problems or failure of the bones to fuse, the abdominal approach has risks involving nearby blood vessels, bowel and urinary structures. Bowel function can take time to recover. In men, nerve injury can cause semen to enter the bladder during ejaculation rather than leave the penis; this is called retrograde ejaculation and can affect fertility.
When to seek urgent help
- Go to an emergency department for new or worsening leg weakness, numbness around the groin, new difficulty passing urine or loss of bladder or bowel control.
- Seek urgent assessment for severe or increasing abdominal pain, increasing abdominal swelling, repeated vomiting, inability to keep fluids down, or inability to pass gas with pain or swelling.
- Seek urgent assessment for new one-sided leg swelling or calf pain. Call 911 for chest pain, sudden breathlessness, collapse, or a suddenly cold, pale, painful leg.
- Contact the surgical team promptly for fever, increasing wound redness or drainage, or pain not controlled by your discharge plan. If you cannot reach the team, seek urgent medical assessment.
Questions for your appointment
- What is the main goal of this treatment for me?
- Which symptoms are likely to improve, and which may remain?
- What are the alternatives and the risks of waiting?
- What help will I need at home, and when can I return to my usual activities?
Further reading
Educational information to support your consultation. The options, risks, and recovery described here may differ from your individual plan. Contact your treating team about new or changing symptoms.