Alternative Surgical Strategy for AxiaLIF Pseudarthrosis: A Series of Three Case Reports

Abstract

Study Design Retrospective case series.

Objective The objective of this study is to describe an alternative technique to attain interbody lumbar fusion in the event of pseudarthrosis after axial lumbar interbody fusion (AxiaLIF) and to assess its safety.

Methods Three patients who suffered from pseudarthrosis after AxiaLIF underwent revision surgery with a DEVEX cage (DePuy Synthes, Raynham, MA, United States) through an anterior approach. We report technical details as well as clinical and radiological results at 12 months follow-up.

Results Preoperative symptoms resolved in all cases. There were no perioperative complications. One patient had a deep venous thrombosis at postoperative day 9. A decrease in visual analog scale score for pain was observed, from 8.67 preoperatively to 2 postoperatively at final follow-up. Radiographic workup after 12 months showed no sign of implant failure or loosening, and fusion was obtained in all cases.

Conclusion Anterior fusion with a DEVEX cage in front of a TranS1 screw (TranS1 screw, Inc., Wilmington, North Carolina, United States) for AxiaLIF pseudarthrosis is safe and effective.

Keywords

lumbar spine - interbody fusion - axial - presacral - pseudarthrosis - revision surgery - AxiaLIF

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• Commentary References

• 1 DeVine JG, Gloystein D, Singh N. A novel alternative for removal of the AxiaLif (TranS1) in the setting of pseudarthrosis of L5-S1. Spine J 2009; 9 (11) 910-915
• 2 Aryan HE, Newman CB, Gold JJ, Acosta Jr FL, Coover C, Ames CP. Percutaneous axial lumbar interbody fusion (AxiaLIF) of the L5-S1 segment: initial clinical and radiographic experience. Minim Invasive Neurosurg 2008; 51 (4) 225-230