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· While the ALIF is still a widely available spine fusion technique, this type of procedure is often combined with a posterior approach (anterior/posterior fusions) because of the need to provide more rigid fixation than an anterior approach alone provides. The ALIF approach is advantageous in that, unlike the PLIF and posterolateral gutter approaches, both the back muscles and nerves remain undisturbed. Another advantage is that placing the bone graft in the front of the spine places it in compression, and bone in compression tends to fuse better.
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