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  • nakurac
    Post count: 8

    Dr. Corenman,

    My question is about the ALIF. I have noticed that you say those fusions have to be supplemented w/posterior instrumentation. Why do you say that? That defeats the purpose of ALIF. There are many stand-alone ALIF cages that have built-in screw system. They are designed not to be supplemented by posterior fixation, unless there is deformity.

    Donald Corenman, MD, DC
    Post count: 8455

    The ALIF is primarily used as an L5-S1 surgery as higher levels are typically fixed by OLIF. The ALIF fixation cages do contain screws that embed into the endplates of the adjacent vertebra. This fixation will hold the cage in place temporarily. The angle of the endplates is in lordosis or wider in the front than in the back which tends to want to expel the cage without fixation.

    Unfortunately, endplate fixation is relatively poor and tends to loosen if left alone. This is the reason that posterior fixation is used as it holds the cage in place rigidly which promotes fusion.

    Dr. Corenman

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