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Axial Lumbar Interbody Fusion
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Pre-Procedure

      • Outcomes

        TERMINOLOGY

        • Abbreviations

          • Axial lumbar interbody fusion (axial LIF)
        • Synonyms

          • AxiaLIF
        • Definitions

          • Minimally invasive approach through presacral space allowing access to lower lumbar disc spaces via vertical route though S1 body
        • Advantages

          • The hope: Access to disc space without risks of direct anterior approach
            • ↓ risk of major vascular injury
            • ↓ risk of sympathetic plexus injury
            • ↓ risk of posterior muscle injury (when combined with minimally invasive pedicle screw fixation)
            • ↓ blood loss, hospital stay, operation time

        PRE-PROCEDURE

        • Indications

          • Contraindications

            • Pre-Procedure Imaging

              PROCEDURE

              • Procedure Steps

                POST-PROCEDURE

                • Expected Outcome

                  • Things to Do

                    OUTCOMES

                    • Complications

                      Selected References

                      1. Epstein NE: Pros, cons, and costs of INFUSE in spinal surgery. Surg Neurol Int. 2:10, 2011
                      2. Li XM et al: The relevant anatomy of the approach for axial lumbar interbody fusion. Spine (Phila Pa 1976). Epub ahead of print, 2011
                      3. Lindley EM et al: Complications of axial lumbar interbody fusion. J Neurosurg Spine. 15(3):273-9, 2011
                      4. Strube P et al: Stand-alone anterior versus anteroposterior lumbar interbody single-level fusion after a mean follow-up of 41 months. J Spinal Disord Tech. Epub ahead of print, 2011
                      5. Tobler WD et al: Minimally invasive axial presacral L5-s1 interbody fusion: two-year clinical and radiographic outcomes. Spine (Phila Pa 1976). 36(20):E1296-301, 2011
                      6. Tobler WD et al: The presacral retroperitoneal approach for axial lumbar interbody fusion: a prospective study of clinical outcomes, complications and fusion rates at a follow-up of two years in 26 patients. J Bone Joint Surg Br. 93(7):955-60, 2011
                      7. Botolin S et al: High rectal injury during trans-1 axial lumbar interbody fusion L5-S1 fixation: a case report. Spine (Phila Pa 1976). 35(4):E144-8, 2010
                      8. Patil SS et al: Clinical and radiological outcomes of axial lumbar interbody fusion. Orthopedics. 33(12):883, 2010
                      9. Smoljanovic T et al: Six-year outcomes of anterior lumbar interbody arthrodesis with use of interbody fusion cages and recombinant human bone morphogenetic protein-2. J Bone Joint Surg Am. 92(15):2614-5; author reply 2615-6, 2010
                      10. Erkan S et al: Biomechanical evaluation of a new AxiaLIF technique for two-level lumbar fusion. Eur Spine J. 18(6):807-14, 2009
                      11. Aryan HE et al: Percutaneous axial lumbar interbody fusion (AxiaLIF) of the L5-S1 segment: initial clinical and radiographic experience. Minim Invasive Neurosurg. 51(4):225-30, 2008
                      Related Anatomy
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                      Related Differential Diagnoses
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                      References
                      Tables

                      Tables

                      KEY FACTS

                      • Terminology

                        • Pre-Procedure

                          • Outcomes

                            TERMINOLOGY

                            • Abbreviations

                              • Axial lumbar interbody fusion (axial LIF)
                            • Synonyms

                              • AxiaLIF
                            • Definitions

                              • Minimally invasive approach through presacral space allowing access to lower lumbar disc spaces via vertical route though S1 body
                            • Advantages

                              • The hope: Access to disc space without risks of direct anterior approach
                                • ↓ risk of major vascular injury
                                • ↓ risk of sympathetic plexus injury
                                • ↓ risk of posterior muscle injury (when combined with minimally invasive pedicle screw fixation)
                                • ↓ blood loss, hospital stay, operation time

                            PRE-PROCEDURE

                            • Indications

                              • Contraindications

                                • Pre-Procedure Imaging

                                  PROCEDURE

                                  • Procedure Steps

                                    POST-PROCEDURE

                                    • Expected Outcome

                                      • Things to Do

                                        OUTCOMES

                                        • Complications

                                          Selected References

                                          1. Epstein NE: Pros, cons, and costs of INFUSE in spinal surgery. Surg Neurol Int. 2:10, 2011
                                          2. Li XM et al: The relevant anatomy of the approach for axial lumbar interbody fusion. Spine (Phila Pa 1976). Epub ahead of print, 2011
                                          3. Lindley EM et al: Complications of axial lumbar interbody fusion. J Neurosurg Spine. 15(3):273-9, 2011
                                          4. Strube P et al: Stand-alone anterior versus anteroposterior lumbar interbody single-level fusion after a mean follow-up of 41 months. J Spinal Disord Tech. Epub ahead of print, 2011
                                          5. Tobler WD et al: Minimally invasive axial presacral L5-s1 interbody fusion: two-year clinical and radiographic outcomes. Spine (Phila Pa 1976). 36(20):E1296-301, 2011
                                          6. Tobler WD et al: The presacral retroperitoneal approach for axial lumbar interbody fusion: a prospective study of clinical outcomes, complications and fusion rates at a follow-up of two years in 26 patients. J Bone Joint Surg Br. 93(7):955-60, 2011
                                          7. Botolin S et al: High rectal injury during trans-1 axial lumbar interbody fusion L5-S1 fixation: a case report. Spine (Phila Pa 1976). 35(4):E144-8, 2010
                                          8. Patil SS et al: Clinical and radiological outcomes of axial lumbar interbody fusion. Orthopedics. 33(12):883, 2010
                                          9. Smoljanovic T et al: Six-year outcomes of anterior lumbar interbody arthrodesis with use of interbody fusion cages and recombinant human bone morphogenetic protein-2. J Bone Joint Surg Am. 92(15):2614-5; author reply 2615-6, 2010
                                          10. Erkan S et al: Biomechanical evaluation of a new AxiaLIF technique for two-level lumbar fusion. Eur Spine J. 18(6):807-14, 2009
                                          11. Aryan HE et al: Percutaneous axial lumbar interbody fusion (AxiaLIF) of the L5-S1 segment: initial clinical and radiographic experience. Minim Invasive Neurosurg. 51(4):225-30, 2008