Minimally Invasive Anterior Lumbar Interbody Fusion
What you should know
Minimally invasive anterior lumbar interbody fusion is surgery to repair vertebrae in your lower back (lumbar). In this surgery, 2 or more vertebrae are joined together using bone grafts or implants, screws, and rods. The surgery is usually done to treat disc disease. Lumbar discs cushion and separate the vertebrae in your back. A minimally invasive anterior lumbar interbody fusion is done through small incisions in the abdomen.
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Problems may happen during your surgery, such as bleeding that cannot be controlled, and may lead to laparotomy (open surgery). Your stomach, intestines, blood vessels, or kidneys may get injured. You could also have trouble breathing, get an infection, or have too much bleeding after surgery. The gas that is used to expand your abdomen may cause shoulder or chest pain for 1 to 2 days after your surgery. Other parts near your spine, such as nerves, blood vessels, ligaments, muscles, and bones may be damaged. You may develop foot weakness or lose feeling in your legs.
Even after surgery, you may still have back pain or problems moving your back. You may have trouble going back to your usual activities. Without treatment, the pain and problems you have with your back may get worse. You may even have problems moving your legs.
The week before your surgery:
- Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
- Ask your caregiver if you need to stop using any of your present medicines. These may include aspirin, ibuprofen, or blood thinners.
- Ask your caregiver before using any over-the-counter or herbal medicine or supplement. If you regularly use these medicines or supplements, tell your caregiver.
- You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
- Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
- If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
- Tell your caregiver if you know or think you are pregnant.
- You may need to have blood and urine tests. Imaging tests, such as x-rays, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) may also be done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
The night before your surgery:
- Remove any nail polish.
- You may be given a pill to help you sleep.
- Ask caregivers about directions for eating and drinking.
The day of your surgery:
- Write down the correct date, time, and location of your surgery.
- What to bring: You may want to bring items such as a toothbrush and bathrobe.
- Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
- Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.
- You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
What will happen:
- You will be given medicine to help you relax or make you drowsy. You will be taken to the operating room. General anesthesia will be given to keep you asleep and free from pain during the surgery. You will be asked to lie on your back. Your abdomen and chest will be cleaned with soap and water. Sheets will be put over you to keep the surgery area clean.
- During a mini-open surgery, a small incision will be made below your belly button. In a laparoscopic surgery, 3 to 4 smaller incisions will be made near your belly button. Caregivers will insert the laparoscope and other instruments into the incisions. The abdomen may be filled with carbon dioxide to make your abdomen swell.
- Once the spine is seen, the disc and excess tissues in the affected area will be removed. Bone grafts and implants will be inserted between the affected vertebrae in place of the damaged disc. Screws and rods will be used to hold the bone graft and implant firmly. The incisions will be closed with stitches and covered with a bandage.
After your surgery:
You may be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is okay. When caregivers see that you are okay, you will be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your wound.
This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.
Contact a caregiver if
- You cannot make it to your appointment on time.
- You have a fever.
- You have a skin infection or an infected wound near the injured area of your spine.
- You have questions or concerns about your surgery.
Seek Care Immediately if
- The problems for which you are having the minimally invasive anterior lumbar interbody fusion get worse.
- You have a lot more pain or have trouble moving your back.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.