Hi Dr. Corenman:
I wanted to follow up with you once again regarding the stand alone ALIF. Although you make excellent points regarding TLIF over ALIF, I don’t believe that many surgeons can perform the TLIF as well as others and therefore they choose ALIF because it is an easier and shorter surgery for them. As a matter of fact, most Dr’s that I have consulted with locally have now moved to ALIF for grade one isthmic spondylolisthesis and claim to have very good results vs TLIF.
1.) They “claim” the surgery is about one hour with one night in the hospital, minimal blood loss and no need for back up pedicle screws.
2.) They “claim” that if the fusion doesn’t take place that they will bring me back in for minimally invasive pedicle screws, but that rarely happens.
3.) I am also hearing that all the negative press of BNP with the stand alone ALIF was not true and it is safe to use now.
4.) They claim at the L5,S1 nerve plexis does not endanger retrograde ejaculation and with a good access surgeon they hardly ever see hernia or digestive issues.
Most have downplayed TLIF because or nerve irritation and claim there is no need to cut muscle and bone to access the disc space when it can be done minimally invasive through the front.
What are your thoughts ? This almost sounds too good to be true !