Comparison of axial and anterior interbody fusions of the L5-S1 segment: a retrospective cohort analysis

J Spinal Disord Tech. 2013 Dec;26(8):437-43. doi: 10.1097/BSD.0b013e318292aad7.


Study design: Retrospective, multicenter review of 96 patients who underwent L5-S1 interbody fusions through either a standard anterior retroperitoneal approach or using a novel device inserted through the presacral space (AxiaLIF) in conjunction with supplemental posterior fixation between 2002 and 2010.

Objective: To compare the radiographic fusion rates and adverse events associated with anterior lumbar interbody fusion (ALIF) and AxiaLIF techniques.

Summary of background data: Interbody fusions of the lumbosacral spine are frequently performed to provide anterior column support, increase the amount of surface area for bone formation, and facilitate deformity reduction. A number of different surgical approaches have been developed for this purpose including minimally invasive techniques.

Materials and methods: Patient information and procedural data were obtained from hospital charts. Multiplanar computed tomography images were evaluated by 2 independent observers to assess fusion success at 24 months using a 4-point grading scale. In addition to reviewing the medical records to identify any complications, all of the sites were queried regarding any device-related adverse events that may have occurred.

Results: According to the radiographic analysis, the arthrodesis rates recorded for the ALIF and AxiaLIF cohorts were 79% and 85%, respectively (P>0.05). The numbers and types of adverse events recorded for these procedures appeared to be similar although there was 1 serious intraoperative complication (iliac artery laceration) noted in the ALIF group.

Conclusions: The radiographic success and adverse events associated with AxiaLIF appear to be similar to that observed for ALIF, suggesting that this technique represents a safe and effective method for achieving an interbody fusion across the L5-S1 disk space when utilized in conjunction with posterior fixation.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Axis, Cervical Vertebra / diagnostic imaging
  • Axis, Cervical Vertebra / surgery*
  • Demography
  • Female
  • Fracture Fixation, Internal
  • Humans
  • Intraoperative Complications / etiology
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Fusion / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome