Skip to main content

Presacral Approaches for Minimally Invasive Spinal Fusion

  • Chapter
  • First Online:
Minimally Invasive Spine Surgery
  • 2457 Accesses

Abstract

The presacral approach is a novel, minimally invasive approach for achieving L5–S1 discectomy and interbody fusion. We review the relevant anatomy regarding this approach and describe technical aspects of surgery using this technique. We also review outcomes of the AxiaLIF technique in the literature and discuss complications related to the procedure and their management.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Anand N, Baron EM, Rosemann R, et al. Safety and complication profile of percutaneous lumbosacral interbody fusion. New Orleans: Congress of Neurological Surgeons; 2009.

    Google Scholar 

  2. Yuan PS, Day TF, Albert TJ, et al. Anatomy of the percutaneous presacral space for a novel fusion technique. J Spinal Disord Tech. 2006;19:237–41.

    Article  PubMed  Google Scholar 

  3. Cragg A, Carl A, Casteneda F, et al. New percutaneous access method for minimally invasive anterior lumbosacral surgery. J Spinal Disord Tech. 2004;17:21–8.

    Article  PubMed  Google Scholar 

  4. Marotta N, Cosar M, Pimenta L, et al. A novel minimally invasive presacral approach and instrumentation technique for anterior L5-S1 intervertebral discectomy and fusion: technical description and case presentations. Neurosurg Focus. 2006;20:E9.

    PubMed  Google Scholar 

  5. Hanson DS, Bridwell KH, Rhee JM, et al. Dowel fibular strut grafts for high-grade dysplastic isthmic spondylolisthesis. Spine (Phila Pa 1976). 2002;27:1982–8.

    Article  Google Scholar 

  6. Sasso RC, Shively KD, Reilly TM. Transvertebral transsacral strut grafting for high-grade isthmic spondylolisthesis L5-S1 with fibular allograft. J Spinal Disord Tech. 2008;21:328–33.

    Article  PubMed  Google Scholar 

  7. Whitecloud 3rd TS, Butler JC. Anterior lumbar fusion utilizing transvertebral fibular graft. Spine (Phila Pa 1976). 1988;13:370–4.

    Article  Google Scholar 

  8. Baker JK, Reardon PR, Reardon MJ, et al. Vascular injury in anterior lumbar surgery. Spine. 1993;18:2227–30.

    Article  CAS  PubMed  Google Scholar 

  9. Sasso RC, Best NM, Mummaneni PV, et al. Analysis of operative complications in a series of 471 anterior lumbar interbody fusion procedures. Spine. 2005;30:670–4.

    Article  PubMed  Google Scholar 

  10. Rajaraman V, Vingan R, Roth P, et al. Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg. 1999;91:60–4.

    CAS  PubMed  Google Scholar 

  11. Brau SA, Delamarter RB, Schiffman ML, et al. Vascular injury during anterior lumbar surgery. Spine J. 2004;4:409–12.

    Article  PubMed  Google Scholar 

  12. Aryan HE, Newman CB, Gold JJ, et al. Percutaneous axial lumbar interbody fusion (AxiaLIF) of the L5-S1 segment: initial clinical and radiographic experience. Minim Invasive Neurosurg. 2008;51:225–30.

    Article  CAS  PubMed  Google Scholar 

  13. Gerszten PC, Tobler WD, Nasca RJ. Retrospective analysis of L5-S1 axial lumbar interbody fusion (AxiaLIF): a comparison with and without the use of recombinant human bone morphogenetic protein-2. Spine J. 2011;11:1027–32.

    Article  PubMed  Google Scholar 

  14. Tobler WD, Gerszten PC, Bradley WD, et al. Minimally invasive axial presacral L5-S1 interbody fusion: two-year clinical and radiographic outcomes. Spine. 2011;36:E1296–301.

    Article  PubMed  Google Scholar 

  15. Tobler WD, Ferrara LA. 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. 2011;93:955–60.

    Article  CAS  PubMed  Google Scholar 

  16. Lee CS, Hwang CJ, Lee DH, et al. Fusion rates of instrumented lumbar spinal arthrodesis according to surgical approach: a systematic review of randomized trials. Clin Orthop Surg. 2011;3:39–47.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Burkus JK, Gornet MF, Schuler TC, 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. 2009;91:1181–9.

    Article  PubMed  Google Scholar 

  18. Slosar PJ, Josey R, Reynolds J. Accelerating lumbar fusions by combining rhBMP-2 with allograft bone: a prospective analysis of interbody fusion rates and clinical outcomes. Spine J. 2007;7:301–7.

    Article  PubMed  Google Scholar 

  19. Botolin S, Agudelo J, Dwyer A, et al. High rectal injury during trans-1 axial lumbar interbody fusion L5-S1 fixation: a case report. Spine. 2010;35:E144–8.

    Article  PubMed  Google Scholar 

  20. Akesen B, Wu C, Mehbod AA, et al. Biomechanical evaluation of paracoccygeal transsacral fixation. J Spinal Disord Tech. 2008;21:39–44.

    Article  PubMed  Google Scholar 

  21. Ledet EH, Tymeson MP, Salerno S, et al. Biomechanical evaluation of a novel lumbosacral axial fixation device. J Biomech Eng. 2005;127:929–33.

    Article  PubMed  Google Scholar 

  22. Fleischer GD, Kim YJ, Ferrara LA, et al. Biomechanical analysis of sacral screw strain and range of motion in long posterior spinal fixation constructs: effects of lumbosacral fixation strategies in reducing sacral screw strains. Spine (Phila Pa 1976). 2012;37:E163–9.

    Article  Google Scholar 

  23. Anand N, Rosemann R, Khalsa B, et al. Mid-term to long-term clinical and functional outcomes of minimally invasive correction and fusion for adults with scoliosis. Neurosurg Focus. 2010;28(3):E6. doi: 10.3171/2010.1.FOCUS09278.

  24. Anand N, Kahwaty S, Daroudi S, et al. Multicenter minimally, invasive AxiaLIF L5–S1 interbody fusion for anterior column support at the end of a long segment construct: feasibility, safety, complications, early and late 3 year outcomes. Gothenberg: International Society for the Study of the Lumbar Spine Gothenberg; 2011.

    Google Scholar 

  25. Tender GC, Miller LE, Block JE. Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: a case series. J Med Case Reports. 2011;5:454.

    Article  PubMed Central  Google Scholar 

  26. Lindley EM, McCullough MA, Burger EL, et al. Complications of axial lumbar interbody fusion. J Neurosurg Spine. 2011;15:273–9.

    Article  PubMed  Google Scholar 

  27. Lee S, Rivadeneira D, Hartl R. Best practices in avoidance detection and treatment of colorectal perforations during AxiaLIF surgery. Wilmington: Trans1 corporation; 2009.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Neel Anand MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Anand, N., Baron, E.M. (2014). Presacral Approaches for Minimally Invasive Spinal Fusion. In: Phillips, F., Lieberman, I., Polly, D. (eds) Minimally Invasive Spine Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5674-2_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-5674-2_19

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-5673-5

  • Online ISBN: 978-1-4614-5674-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics