Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
HSS J. 2012 Jul;8(2):116-21. doi: 10.1007/s11420-011-9227-y. Epub 2011 Dec 13.
Current methods to achieve lumbosacral interbody fusion have been complicated by approach-related morbidity, nerve root or cauda equina injury, or difficulty in implanting a large lordotic graft posteriorly. There is little information in the literature evaluating the presacral axial approach to the lumbosacral disc space.
QUESTIONS/PURPOSES: What are the short-term clinical and radiographic outcomes in patients undergoing axial lumbosacral interbody fixation and fusion at the end of long fusion constructs using the AxiaLIF implant (Trans1 Inc., Wilmington, NC, USA)? Furthermore, what complications are associated with this procedure?
We performed a retrospective evaluation of nine patients who underwent presacral axial lumbosacral interbody fixation and fusion at the end of long fusion constructs using the AxiaLIF implant. Preoperative diagnoses included adjacent segment degeneration below a long fusion construct for adult scoliosis and progressive sagittal plane deformity.
There were two pseudoarthroses, one at L4-5 and one at L5-S1. No major complications occurred. There were no significant differences in coronal or sagittal plane alignment at the time periods measured. There was no significant difference in implant position between immediate postoperative and final follow-up periods. There were significant postoperative improvements in Scoliosis Research Society-22 scores, specifically in the pain, self-image, and satisfaction with management domains.
The axial lumbosacral interbody fusion is a minimally invasive and safe method to obtain lumbosacral fixation and arthrodesis distal to a long fusion construct. Longer follow-up of larger numbers of patients are needed prior to recommending this procedure as a routine method to fuse L4-5 or L5-S1.
目前，实现腰骶体间融合的方法因入路相关的发病率、神经根或马尾神经损伤，或在后路植入大的前凸移植物的困难而变得复杂。文献中几乎没有关于经前路腰骶椎间盘空间的评估。
问题/目的：使用 AxiaLIF 植入物（美国北卡罗来纳州威尔明顿的 Trans1 公司）在长融合结构的末端进行轴向腰骶体间固定和融合的患者的短期临床和影像学结果如何？此外，该手术与哪些并发症相关？
我们对 9 例使用 AxiaLIF 植入物在长融合结构末端进行前路腰骶体间固定和融合的患者进行了回顾性评估。术前诊断包括长融合结构下方的成人脊柱侧凸和矢状面畸形的相邻节段退变。
有 2 例假关节，1 例在 L4-5，1 例在 L5-S1。没有发生重大并发症。在测量的时间段内，冠状面或矢状面排列没有显著差异。在即时术后和最终随访期间，植入物位置没有显著差异。Scoliosis Research Society-22 评分有显著改善，特别是在疼痛、自我形象和管理满意度方面。
轴向腰骶体间融合是一种微创且安全的方法，可在长融合结构的远端获得腰骶固定和融合。在推荐该手术作为融合 L4-5 或 L5-S1 的常规方法之前，需要对更多患者进行更长时间的随访。
