Spine Surgeon Explains Carson Daly’s Back Surgery

In this video, San Antonio-based orthopedic surgeon Antonio Webb, MD, discusses details of anterior lumbar interbody fusion surgery.

Following is a transcript of his remarks (note that errors are possible):

Webb: Carson Daly from NBC’s “Today Show” recently underwent an ALIF procedure, a spine operation. In this video, I’m going to break it down for you guys.

What’s up, everyone? Dr. Webb here, an orthopedic spine surgeon located in San Antonio, Texas, and recently Carson Daly just underwent an ALIF procedure. So, what is an ALIF procedure?

An ALIF is anterior lumbar interbody fusion. I recently put out a video about this surgery, and I’ll put it right up here. But essentially what this entails is going in the front of the spine, removing degenerated and diseased discs, and replacing it with a spacer, either metal, plastic such as PEEK, or some type of allograft.

There are a couple different ways to approach the spine. This is the front of the spine here. You can go in the front of the spine and fuse it, essentially holding and ensuring that two segments of the spine come together as one, two parts of the spine. That’s called a fusion. We can go in the front of the spine. We can go on the side of the spine; that’s called a lateral. Or we can go posteriorly, called a TLIF, depending on which direction that we go. Or a PLIF, if it’s directly posterior. A couple of different ways to approach it: anteriorly, lateral, transforaminal, or directly posterior. These are ways to fuse a patient’s spine.

Well, he recently underwent this operation, which he called a success, and he quoted, “Mentally, physically,” that he’s feeling better. “The future is bright, but there is still a lot of work to do.” This accident or degeneration all stemmed from a snowmobile accident in 1997 while he was working for MTV. He just underwent this operation, the ALIF, at the University of Southern California Spine Center.

He also mentioned that the past 7 weeks of recovery had been eye-opening in a number of ways. He has been living his life pain-free for the first time in decades, and this is something that I can attest to. This is one of my favorite surgeries and operations to do because patients do fantastic from it. You’re able to clean out that part of the disc. You’re able to clean out that part of the spine and indirectly decompress it to take the pressure off the spinal elements. Patients who have disc degeneration disease or lumbar stenosis, which is tightening or narrowing of the spinal canal, this is a great option for that.

The question that I get all the time is, how do you choose one approach over the other? How do you choose to go through the front, the side, or the back? Well, that depends a lot on 1) the patient’s anatomy. Are the vessels that are lying directly in front of the spine amendable to moving those vessels out of the way? Typically, we do this surgery with the help of a vascular surgeon. That vascular surgeon is there to move the vessels out of the way and make the incision, and then get the spine surgeon down to the spine.

It also depends on what we’re essentially trying to do. If we’re trying to restore some anatomy, which means some curvature, or lordosis in the back, then going through the front is most likely the best way to … it is the best way to do that to restore lumbar lordosis.

If a patient has had previous surgery in the front, like some type of big cancer reconstruction or some type of large abdominal surgery, there is a lot of scar tissue and we can’t go through the front usually in those situations. Or if the patient’s belly is extremely large, that makes it challenging to go through the front, so we have to approach the spine through the back.

This is a great operation called an ALIF, anterior lumbar interbody fusion. Carson Daly from NBC’s “Today Show” recently underwent this surgery. He reports that he is feeling good. He quoted, “I wish I would have got this surgery done sooner.” This is Dr. Webb. Thank you for watching. We’ll see you next time.

Antonio Webb, MD, is a spine surgeon located in San Antonio, Texas. You can learn more on his website or YouTube channel.