Axial lumbar interbody fusion (AxiaLIF) approach for adult scoliosis.
Summary of "Axial lumbar interbody fusion (AxiaLIF) approach for adult scoliosis."
AxiaLIF was initially advocated as a minimally invasive, presacral lumbar fusion approach. Its use has expanded in to adult scoliosis surgeries.
Current literature about AxiaLIF for degenerative lumbar surgery and adult scoliosis surgery were reviewed. Anatomy, biomechanical properties, clinical results, and complications were summarized.
Anatomically, AxiaLIF is relatively safe even though traversing blood vessels, and the pelvic splanchnic nerve can be at risk. AxiaLIF can provide significant stiffness compared to the intact spine, but posterior supplementation is recommended. AxiaLIF in the long construct for adult scoliosis surgeries can protect the S1 screw as effectively as pelvic fixation. Successful clinical outcomes after AxiaLIF were reported in the degenerative lumbar spine, adult scoliosis, and spondylolisthesis. It can facilitate a high fusion rate up to 96 % without BMP. Complications include pseudarthrosis, rectal injury, transient nerve irritation, and intrapelvic hematoma.
AxiaLIF is a relatively safe procedure, and it provides good clinical results in both short constructs and long constructs for adult scoliosis surgery. For a safer procedure, surgeons should seek out prior colorectal surgical history and review preoperative imaging studies carefully.
Hospital for Special Surgery, 525 East 71st Street, #9J, New York, NY, 10021, USA.
This article was published in the following journal.
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22573050
- DOI: http://dx.doi.org/10.1007/s00586-012-2351-7
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Medical and Biotech [MESH] Definitions
The GENETIC RECOMBINATION of the parts of two or more GENES resulting in a gene with different or additional regulatory regions, or a new chimeric gene product. ONCOGENE FUSION includes an ONCOGENE as at least one of the fusion partners and such gene fusions are often detected in neoplastic cells and are transcribed into ONCOGENE FUSION PROTEINS. ARTIFICIAL GENE FUSION is carried out in vitro by RECOMBINANT DNA technology.
Tapping of the subarachnoid space in the lumbar region, usually between the third and fourth lumbar vertebrae.
A genus of SPONGES in the family Axinellidae, comprised of a choanosomal skeleton differentiated in the axial and extra-axial region. The type species is Axinella polypoides.
The GENETIC RECOMBINATION of the parts of two or more GENES, including an ONCOGENE as at least one of the fusion partners. Such gene fusions are often detected in neoplastic cells and are transcribed into ONCOGENE FUSION PROTEINS.
The lumbar and sacral plexuses taken together. The fibers of the lumbosacral plexus originate in the lumbar and upper sacral spinal cord (L1 to S3) and innervate the lower extremities.