Anterior Lumbar Interbody Fusion (ALIF)

Last edited and medically reviewed by Alaric Steinmetz on 13.04.2026

ALIF refers to stabilization of at least two Vertebral bodies from the anterior aspect of the Vertebral body.

Approach

The approach is retroperitoneal, usually through an abdominal Pfannenstiel incision.

Risks

The approach primarily carries a risk of retrograde ejaculation in men, as well as vascular injuries. Due to the vascular anatomy, ALIF is best suited at the L5/S1 level [^1] [^2].

Figure

LIFs — Illustration of the various LIF approaches. Figure adapted from Mobbs, Ralph J., et al. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. Journal of Spine Surgery 1.1 (2015): 2, under the CC BY-NC-ND 4.0 license.

ALIF intraoperatively — Intraoperative image of an ALIF at the L5/S1 level. Figure adapted from Mobbs, Ralph J., et al. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF. Journal of spine surgery 1.1 (2015): 2. under the CC BY-NC-ND 4.0 license.

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