Stand-alone anterior lumbar discectomy and fusion with plate: initial experience

Preliminary results of stand-alone ALDF with plate suggest it may be safe and effective for the surgical treatment of patients with degenerative disc disease of the lumbar spine. Long-term follow-up is clearly needed. Subsidence is diminished with ALDF and plating compared with ALIF with posterior instrumentation. It is unclear at this time which subset of patients may ultimately require posterior hardware supplementation, but those with circumferential stenosis or severe facet disease are not ideal candidates for ALDF with plate. For some patients in whom lumbar arthroplasty is not indicated, or as a salvage procedure, ALDF with plate may be a satisfactory alternative and may eliminate the need for a supplemental posterior procedure.