In an Anterior Lumbar Fusion, the spine is approached through the lower abdomen. The approach is performed by a vascular surgeon who is experienced in the procedure. Once the disc is exposed, it can be safely removed. A synthetic spacer is then packed with bone graft material and placed within the disc space. A titanium plate is then used to lock the spacer in place. The advantage of the Anterior approach is that it spares the back muscles and, therefore, may be less painful and have a faster recovery. Typical hospital stay is 2 nights. The most common indication for this surgery is for painful degenerative disc disease, where the disc has worn out and collapsed, or spondylolisthesis, where the disc has slipped and has become unstable.