الفهرس 
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Abstract
The ALIF is a modern approach for DDD aiming to restoration of disc height and relief of back pain without interruption of the posterior segments and facet joints.
While the ALIF is still a widely available spine fusion technique, this type of procedure might be combined with a posterior approach (anterior/posterior fusions) in case of spinal instability because of the need to provide more rigid fixation than an anterior approach alone provides.
The aim of the present work was to evaluate the role of stand alone anterior lumbar interbody fusion in 40 patients with degenerative lumbar disc disease admitted to the Neurosurgery Department at Alexandria Main University Hospital.
The retroperitoneal approach was used in this study. The operating system for the ALIF technique that was used is that of the anterior thoracolumbar interbody fusion cage for arthrodesis of Spineway company.
Back pain was assessed before and after the procedure. The VAS of back pain decreased dramatically in the 2,6 months and 1 year follow up intervals after ALIF compared to the preoperative state. The mean at the preoperative state was 6.78 ± 0.862, after 2 months the mean was 1.8 ± 0.992, after 6 months the mean was 0.65 ± 0.834, after 1 year the mean was 0.25 ± 0.588.
Disc height, lumbar lordosis and foraminal diameter showed marked improvement after the procedure. The minimal lumbar lordosis preoperatively was 15 degree and the maximal one was 49 degree. Postoperatively, the minimal lumbar lordosis was 21 degree and the maximal one was 51 degree. The minimal disc height preoperatively was 0.5 cm and the maximal one was 1.37 cm. Postoperatively, the minmal disc height was 1.15 cm and the maximal one was 1.50 cm. The minimal longituidinal foraminal diameter preoperatively was 0.7 cm and the maximal one was 1.90 cm. Postoperatively, the minimal longituidinal foraminal diameter was 1.20 cm and the maximal one was 2.20 cm.
Complications of the procedure were favourable and comparable to literature in the form of superficial wound infection (2 patients), intraoperative bleeding (1 patient), cage subsidence (1 patient) and peritoneal tears (4 patients). No lymphocele or retrograde ejaculation or impotence or bowel injury or pseudoarthrosis.