Comparison of Axial and Anterior Interbody Fusions of the L5–S1 Segment

Whang, Peter G.; Sasso, Rick C.; Patel, Vikas V.; Ali, Raed; Fischgrund, Jeffrey S.

doi:10.1097/bsd.0b013e318292aad7

Cited by 17 publications

(9 citation statements)

References 47 publications

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“…9, 31 The overall pseudarthrosis rate at L5-S1 following axial interbody arthrodesis was 6.9% (95% CI 1.0%-16.2%). Failed fusion was verified by CT in 12 of the 15 studies and by radiography in the remaining 3 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Only a single article comparing axial interbody fusions and another interbody fusion technique was identified. 31 Because no other comparative studies were identified, that single comparative article was treated as a case series, and only patients from the Axialif arm were included in our systematic review. All reported complications were noted, including pseudarthrosis at L5-S1, revision and/or subsequent surgery, infections, postoperative radiculopathy, neurological deficits, bowel perforations, retroperitoneal hematomas and/or vascular injury, and significant medical complications (for example, myocardial infarction, stroke, and so forth).…”

Section: Data Extractionmentioning

confidence: 99%

See 1 more Smart Citation

Axial interbody arthrodesis of the L5–S1 segment: a systematic review of the literature

Schroeder¹,

Kepler²,

MBA³

et al. 2015

SPI

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OBJECT The object of this study was to determine the fusion rate and safety profile of an axial interbody arthrodesis of the L5–S1 motion segment. METHODS A systematic search of MEDLINE was conducted for literature published between January 1, 2000, and August 17, 2014. All peer-reviewed articles related to the fusion rate of L5–S1 and the safety profile of an axial interbody arthrodesis were evaluated. RESULTS Seventy-four articles were identified, but only 15 (13 case series and 2 retrospective cohort studies) met the study inclusion criteria. The overall pseudarthrosis rate at L5–S1 was 6.9%, and the rate of all other complications was 12.9%. A total of 14.4% of patients required additional surgery, and the infection rate was 5.4%. Deformity studies reported a significantly increased rate of complications (46.3%), and prospectively collected data demonstrated significantly higher complication (36.8%) and revision (22.6%) rates. Lastly, studies with a conflict of interest reported lower complication rates (12.4%). CONCLUSIONS A systematic review of the literature indicates that an axial interbody fusion performed at the lumbosacral junction is associated with a high fusion rate (93.15%) and an acceptable complication rate (12.90%). However, these results are based mainly on retrospective case series by authors with a conflict of interest. The limited prospective data available indicate that the actual fusion rate may be lower and the complication rate may be higher than currently reported.

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Section: Resultsmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

Axial interbody arthrodesis of the L5–S1 segment: a systematic review of the literature

Schroeder¹,

Kepler²,

MBA³

et al. 2015

SPI

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“…This finding was challenged by results of a recent retrospective study by Yi et al, which reported no significant difference in the rate of fusion for 36 patients who underwent axial lumbosacral interbody fusion or TLIF 40) . Similarly, two retrospective analyses comparing axial lumbosacral interbody fusion to ALIF reported no significant difference in fusion rates for the approaches 37,41) . The Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) are validated, vigorous condition-specific outcome measures used in the management of spinal disorders to assess function and back pain, respectively 42) .…”

Section: Resultsmentioning

confidence: 96%

Paracoccygeal Transsacral Approach: A Rare Approach for Axial Lumbosacral Interbody Fusion

Siddiqi

Chacon²,

Figueras

et al. 2021

Spine Surg Relat Res

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Lumbosacral interbody fusion is a mainstay of surgical treatment for degenerative spinal pathologies causing chronic pain and functional impairment. However, the optimal technique for this procedure remains controversial. Well-established open approaches, including anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), and transforaminal lumbar interbody fusion (TLIF), have historically been the standard of practice. A recent paradigm shift in spinal surgery has led to the investigation of minimally invasive approaches to mitigate tissue damage without compromising outcomes. This extensive review aims to examine current clinical and biomechanical evidence on the paracoccygeal transsacral approach to an axial lumbosacral interbody fusion. Since this technique was first described in 2004, accumulating evidence suggests it results in high fusion rates, consistent improvements in pain and function, reduced perioperative morbidity, and low rates of complication. Although early clinical outcomes have been promising, there is a paucity of comparative data investigating outcomes of the paracoccygeal transsacral approach to traditional alternatives and other minimally invasive techniques. Here, we summarize current evidence and discuss pertinent topics for the spinal surgeon considering this novel approach, including indications, advantages, relevant anatomy, contraindications, and technical considerations.

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“…6,23,24 The Roy-Camille lateral mass screw-plate technique was introduced into the US by Paul Cooper, M.D. 1,4,8,9,12,14,16,22,26 Despite this vast clinical experience, no system has been approved by the Food and Drug Administration (FDA) for "on label" usage in the subaxial cervical spine for the specific purpose of lateral mass fixation. 7,9 In the 1990s, second-generation plating systems emerged, which allowed more versatility in screw position through the plate holes.…”

Section: Lateral Mass Screw Fixation In the Cervical Spinementioning

confidence: 99%