Posterior instrumentation improves the stabilities of Brantigan and Bagby and Kuslich (BAK) methods of posterior lumbar interbody fusion across the L4–L5 segments in a cadaveric model

Object Paracoccygeal transsacral fixation is a novel percutaneous technique for arthrodesis of L5–S1 and L4–5 (Axial Lumbar Interbody Fusion [AxiaLIF]). There are no reports on feasible revision strategies. The goal of this paper is to analyze the surgical details of failed AxiaLIF constructs and to describe revision strategies. Methods The medical charts, operative records, and imaging studies of 5 patients with failed multisegment instrumentation using the AxiaLIF device were reviewed. Results AxiaLIF constructs were revised in 5 patients with a mean age of 58.4 years. All AxiaLIF devices were part of multisegment fusion constructs for revision surgery and were revised an average of 15 months after implantation. Two AxiaLIF devices were percutaneously retrieved; one because of excessive bone resorption around the AxiaLIF screw, and the other because of chronic hardware infection. In these 2 patients, the anterior column was subsequently stabilized via anterior lumbar interbody fusion. In the other 3 patients, the AxiaLIF device was left in situ. In 2 of these patients the anterior column was stabilized with bilateral L5–S1 posterior lumbar interbody fusion, and in the remaining patient with L4–5 instability the posterior instrumentation only was revised. Revision surgeries were well tolerated. One patient suffered from a wound dehiscence of the back wound. Conclusions AxiaLIF devices are safely retrieved using percutaneous technique. Both anterior and posterior revision strategies may be used to achieve anterior column fixation.

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Biomechanical Evaluation of a Novel Autogenous Bone Interbody Fusion Cage for Posterior Lumbar Interbody Fusion in a Cadaveric Model

Spine ◽

10.1097/brs.0000000000000291 ◽

2014 ◽

Vol 39 (11) ◽

pp. E684-E692 ◽

Cited By ~ 3

Author(s):

Le Wang ◽

Kyle T. Malone ◽

Hai Huang ◽

Zhenshan Zhang ◽

Zhi Zhang ◽

...

Keyword(s):

Interbody Fusion ◽

Posterior Lumbar Interbody Fusion ◽

Autogenous Bone ◽

Lumbar Interbody Fusion ◽

Biomechanical Evaluation ◽

Fusion Cage ◽

Cadaveric Model ◽

Interbody Fusion Cage

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Surgical treatment of double-level isthmic spondylolisthesis

Journal of Neurosurgery Spine ◽

10.3171/2013.12.spine13521 ◽

2014 ◽

Vol 20 (4) ◽

pp. 396-399 ◽

Cited By ~ 4

Author(s):

Deyong Song ◽

Zhong Chen ◽

Dewei Song

Keyword(s):

Surgical Treatment ◽

Interbody Fusion ◽

Unusual Case ◽

Posterior Instrumentation ◽

Posterior Lumbar Interbody Fusion ◽

Autogenous Bone ◽

Lumbar Interbody Fusion ◽

Isthmic Spondylolisthesis ◽

Short Term

Isthmic spondylolisthesis, which is demonstrated in 4%–6% of the general population, is one of the most common types of spondylolisthesis. However, double-level isthmic spondylolisthesis is extremely rare. Only a few reports have examined the outcomes of surgical treatment of double-level spondylolisthesis. The authors present an unusual case of double-level isthmic spondylolisthesis of the lumbar spine. The patient had low-back pain for 20 years and did not respond to conservative treatment. Radiographs revealed bilateral pars defects at L-4 and L-5. Grade 2 isthmic spondylolisthesis was present, both at L4–5 and at L5–S1. The patient underwent decompression, reduction, and posterior lumbar interbody fusion with autogenous bone chips from posterior decompression. At follow-up after 12 months, the patient was free of pain, slippage was corrected, and fusion was achieved. Posterior lumbar interbody fusion with posterior instrumentation and reduction may yield good functional short-term results for double-level spondylolisthesis.

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