Safety and efficacy of combining Anterior Lumbar Interbody Fusion (ALIF) and Total Disc Replacement (TDR) in treatment of symptomatic lumbar degenerative disc disease. (Middle term results) Giuseppe Lambros Morassi¹, Roozbeh Shafafy², Masood Shafafy¹ 1)The Centre for Spinal Studies and Surgery (CSSS) Queen's Medical Centre of the Nottingham University Hospital 2) Royal Surrey County Hospital, Guildfordults)