ACDF Surgery Sydney | ALIF Surgery Sydney

What are ACDF and ALIF, and why could these procedures benefit me?

“ACDF and ALIF are keyhole fusion surgeries that stabilise the spine and relieve nerve pressure, helping you recover with less pain and a quicker return to daily life.” 

Dr Shanu Gambhir | Neurosurgeon Sydney

Dr Shanu Gambhir

Neurosurgeon Sydney

ACDF (Anterior Cervical Discectomy and Fusion) and ALIF (Anterior Lumbar Interbody Fusion) are advanced, minimally invasive spine surgeries used to stabilise parts of the spine and relieve nerve pain. In both fusions, I remove the problematic disc and replace it with a bone graft or cage. This stabilises the spine at that level, helping relieve pain and prevent further issues. 

ACDF Surgery Sydney | ALIF Surgery Sydney

ACDF & ALIF Keyhole Spine Surgery Sydney

3 reasons why ACDF or ALIF surgery may be best for you

Here are three reasons why ACDF or ALIF surgery might be the right option for you:

Severe pain or nerve symptoms

When neck or lower back pain becomes too intense or starts affecting your arms or legs, these surgeries can offer relief by taking the pressure off the affected nerves. 

Spinal instability

ACDF and ALIF can help stabilise areas of the spine that have become weakened or unstable, allowing you to move with confidence and less discomfort. 

Long-lasting support with minimal impact

Both ACDF and ALIF use hardware like screws, or a stabilising cage to hold the spine in place while it heals. This fusion is designed to be long-lasting, providing stability and support with less disruption to the surrounding muscles and tissues.

If you’re managing symptoms with non-surgical treatments, it’s often fine to keep doing so. Most of the time, neck and back pain won’t cause permanent damage to the spine. Surgery is usually only recommended when symptoms interfere with daily life or non-surgical options haven’t worked. 

What ACDF and ALIF surgeries can treat

ACDF and ALIF keyhole surgeries can help with several spine conditions:

  • Herniated discs: When a disc in the neck (for ACDF) or lower back (for ALIF) bulges or ruptures, it can press on nearby nerves. These surgeries relieve that pressure, helping to reduce pain, numbness, or tingling.
  • Spinal instability: Conditions like degenerative disc disease can lead to instability in the spine. ACDF and ALIF fuse the affected vertebrae, providing stability and helping reduce pain.
  • Spinal stenosis: Narrowing of the spinal canal can compress nerves, causing pain or weakness. ACDF or ALIF can help by opening up the space around the nerves, reducing symptoms.
  • Spondylolisthesis: This occurs when one vertebra slips over another, which can cause pain or nerve compression. ALIF surgery helps stabilise the affected vertebrae to relieve symptoms.

Some conditions aren’t suitable for ACDF or ALIF and might require different surgical approaches:

  • Severe deformities: Complex spine issues, like advanced scoliosis, usually need more extensive surgery for alignment and stabilisation.
  • Multiple-level issues: When multiple areas of the spine are involved, fusion surgeries might not be the best choice and may need a different approach to maintain mobility.

In these cases, other types of spine surgery may be recommended.

ACDF Surgery Sydney | ALIF Surgery Sydney

How ACDF and ALIF keyhole surgeries work

ACDF and ALIF are keyhole fusion surgeries that focus on stabilising the spine and relieving pressure on nerves through a minimally invasive approach. Here’s a breakdown of each step:

Small incisions

For ACDF, an incision is made at the front of the neck; for ALIF, it’s made in the lower abdomen. These small, carefully placed incisions help avoid significant disruption to surrounding tissues.

Disc removal

The damaged disc is removed to reduce nerve compression. This removal relieves the immediate pressure causing pain and symptoms.

Insertion of stabilising cage with or without bone graft

In place of the disc, a bone graft or spacer is inserted to keep the proper spacing between vertebrae.

Fusion with screws or stabilising cage

To stabilise the area, screws, or a cage are used to hold the vertebrae together, allowing them to fuse over time. This hardware provides support as the bone fusion develops, creating a stable structure for long-term relief. 

Minimal disruption to tissues

The minimally invasive approach uses keyhole incisions, reducing trauma to muscles and surrounding tissue and aiding in faster recovery.

Completion and closing

The incision is closed with dissolvable stitches or a small bandage. The goal is to keep recovery time and discomfort to a minimum while ensuring stability.

ACDF and ALIF procedures generally require a few days in the hospital, but recovery times vary. Here’s what to expect:

  • Hospital stay: Most patients stay in the hospital for 1 to 4 days, depending on their condition and response to the surgery.
  • Early movement: Gentle walking and light movement are encouraged soon after surgery to aid circulation and reduce stiffness.
  • Return to daily activities: You can often return to light activities within a few days. More strenuous activities may be limited until the fusion is complete.
  • Follow-up care: Follow-up appointments are essential to track healing and the fusion’s progress. Physiotherapy may also be recommended to rebuild strength and mobility.

Adhering to post-operative instructions is crucial for a safe recovery and the best possible outcome.

The risk of complications is quite low, but as with any surgery, there are still some risks like infection, bleeding, blood clots, or anaesthesia reactions, alongside specific spine-related risks:

  • Nerve damage: There is a small risk of nerve injury, which could lead to numbness, weakness, or, in rare cases, other neurological symptoms.
  • Swallowing or voice changes (for ACDF): Since ACDF is performed through the front of the neck, some patients may experience temporary difficulty swallowing or changes in voice. These symptoms typically improve over time.
  • Spinal fluid leak: Occasionally, a tear in the membrane around the spinal cord can occur, causing a spinal fluid leak that might need additional treatment.
  • Adjacent segment disease: Increased stress on nearby vertebrae might lead to degeneration over time.
  • Hardware complications: Screws, or cages used to stabilise the spine may shift or break over time, which might necessitate revision surgery.
  • ALIF is performed through the abdomen, which carries a small risk of bowel injury, although this is rare.

I take every step to minimise these risks and ensure a safe, effective recovery, with the likelihood of significant complications being very low.

Spine Surgeon Sydney

Why I became a spine surgeon

My journey to becoming a spine surgeon began when I was a kid, watching my mum struggle with pain after dislocating her shoulder. I remember feeling helpless, knowing none of us could relieve her discomfort. Seeing how much it affected her daily life inspired me to become a doctor. As I trained, I found myself drawn to neurosurgery, fascinated by its complexity and its potential to truly change lives. Over time, I developed a passion for helping people with complex spine issues, knowing that the right care could make a real difference in easing pain and restoring quality of life. 

Why choose me as your spine surgeon

I specialise in advanced spine surgeries like ACDF and ALIF, using techniques that minimise disruption while providing effective, lasting relief. My approach is always patient-focused—I take the time to listen, explain your options clearly, and customise the treatment to fit your needs.

With extensive experience in minimally invasive procedures and fusion surgeries, my goal is to relieve your pain and help improve your quality of life.