The Internet Journal of Minimally Invasive Spinal Technology™ ISSN: 1937-8254

The Internet Journal of Minimally Invasive Spinal Technology is the official online journal of ISMISS/SICOT (International Society of Minimally Invasive Spinal Surgery, affiliate of SICOT) and AAMISMS (American Academy of Minimally Invasive Spine Surgery and Medicine)

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Combined XLIF and AxiaLIF Techniques for Minimally-Invasive Surgical Access

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Burak M. Ozgur M.D.
Department of Neurological Surgery
University of California, San Diego

Marlon Mathews MD
Department of Neurological Surgery
University of California, San Diego

William Taylor MD
Department of Neurological Surgery
University of California, San Diego

Citation: B. M. Ozgur, M. Mathews & W. Taylor : Combined XLIF and AxiaLIF Techniques for Minimally-Invasive Surgical Access . The Internet Journal of Minimally Invasive Spinal Technology. 2008 Supplement I - to IJMIST Vol 1 No 2

Abstract

Introduction: The L5-S1 disc space can be a challenging level for spinal fusion given the lumbar and sacral transitional anatomy. Technology and innovation however have combined in easing this task. In select patients, we have found that a minimally-invasive, viable, and often preferable option is to combine a lateral retroperitoneal trans-psoas approach (XLIF) with a posterior paracoccygeal trans-S1 approach (AxiaLIF). This construct can then be fortified with percutaneous pedicle screw instrumentation.
Methods: We performed a retrospective chart review of 5 patients in particular who presented with degenerative disc disease of the lumbo-sacral spine. All patients failed non-operative management, demonstrated chronic-progressive symptoms consistent with imaging. We performed a combined multilevel XLIF followed by an AxiLIF and percutaneous pedicle screw instrumented fusion.
Results: All patients did well radiographically and clinically. They experience no significant blood loss, did not require blood transfusions, were up and out of bed post-op day 1 and went home by postop day 3. Postoperative imaging demonstrates a biomechanically sound construct. Patients reported immediate relief of radiculopathy and significant improvement of their low back pain.
Conclusions: This combination of the XLIF and AxiaLIF techniques has allowed a surgeon to perform minimally-invasive surgical techniques while alleviating patient suffering, achieving a stable construct, and avoiding significant potential complications from traditional approaches.

This article was last modified on Fri, 13 Feb 09 13:44:22 -0600

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	The Internet Journal of Minimally Invasive Spinal Technology™ ISSN: 1937-8254 \| Home \| Editors \| Current Issue \| Archives \| Instructions for Authors \| Disclaimer \| Share with others \| The Internet Journal of Minimally Invasive Spinal Technology is the official online journal of ISMISS/SICOT (International Society of Minimally Invasive Spinal Surgery, affiliate of SICOT) and AAMISMS (American Academy of Minimally Invasive Spine Surgery and Medicine) Combined XLIF and AxiaLIF Techniques for Minimally-Invasive Surgical Access Read printer friendly Subscribe in a reader Share with others Burak M. Ozgur M.D. Department of Neurological Surgery University of California, San Diego Marlon Mathews MD Department of Neurological Surgery University of California, San Diego William Taylor MD Department of Neurological Surgery University of California, San Diego Citation: B. M. Ozgur, M. Mathews & W. Taylor : Combined XLIF and AxiaLIF Techniques for Minimally-Invasive Surgical Access . The Internet Journal of Minimally Invasive Spinal Technology. 2008 Supplement I - to IJMIST Vol 1 No 2 Abstract Introduction: The L5-S1 disc space can be a challenging level for spinal fusion given the lumbar and sacral transitional anatomy. Technology and innovation however have combined in easing this task. In select patients, we have found that a minimally-invasive, viable, and often preferable option is to combine a lateral retroperitoneal trans-psoas approach (XLIF) with a posterior paracoccygeal trans-S1 approach (AxiaLIF). This construct can then be fortified with percutaneous pedicle screw instrumentation. Methods: We performed a retrospective chart review of 5 patients in particular who presented with degenerative disc disease of the lumbo-sacral spine. All patients failed non-operative management, demonstrated chronic-progressive symptoms consistent with imaging. We performed a combined multilevel XLIF followed by an AxiLIF and percutaneous pedicle screw instrumented fusion. Results: All patients did well radiographically and clinically. They experience no significant blood loss, did not require blood transfusions, were up and out of bed post-op day 1 and went home by postop day 3. Postoperative imaging demonstrates a biomechanically sound construct. Patients reported immediate relief of radiculopathy and significant improvement of their low back pain. Conclusions: This combination of the XLIF and AxiaLIF techniques has allowed a surgeon to perform minimally-invasive surgical techniques while alleviating patient suffering, achieving a stable construct, and avoiding significant potential complications from traditional approaches. This article was last modified on Fri, 13 Feb 09 13:44:22 -0600 This page was generated on Wed, 17 Mar 10 15:34:30 -0500, and may be cached.
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