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Research ArticleFull Length Article
Open Access

Minimally invasive trans-sacral approach to L5-S1 interbody fusion: Preliminary results from 1 center and review of the literature

W. Daniel Bradley, Michael S. Hisey, Sunita Verma-Kurvari and Donna D. Ohnmeiss
International Journal of Spine Surgery January 2012, 6 110-114; DOI: https://doi.org/10.1016/j.ijsp.2011.12.005
W. Daniel Bradley
aTexas Back Institute, Denton, TX
MD
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  • For correspondence: dbradley@texasback.com
Michael S. Hisey
aTexas Back Institute, Denton, TX
MD
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Sunita Verma-Kurvari
bTexas Back Institute Research Foundation, Plano, TX
PhD
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Donna D. Ohnmeiss
bTexas Back Institute Research Foundation, Plano, TX
DrMed
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    VAS scores assessing back and leg pain both improved significantly (P < .01, paired t test).

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    Table 1

    Overview of patient population and procedures

    Data
    Gender
     Male18 (43.9%)
     Female23 (56.1%)
    Mean age (yr)47.0 (range, 14–68)
    Mean BMI28.6 (range, 18.3–37.7)
    Smoker15 (36.6%)
    Prior lumbar surgery14 (34.1%)
    Procedure
     Single-level AxiaLIF + PLF28 (68.3%) (1 uninstrumented)
     Single-level AxiaLIF only5 (12.2%)
     Single-level AxiaLIF + PLF ≥1 level3 (7.3%)
     2-level AxiaLIF + PLF4 (9.7%)
     AxiaLIF + PLF (L5-S1) + XLIF + PLF (L4-5)1 (2.4%)
    Mean clinical follow-up (mo)22.2 (range, 6–43)
    Mean radiographic follow-up (mo)16.6 (range, 4–38)
    • Abbreviation: XLIF, extreme lateral interbody fusion.

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    Table 2

    Perioperative data for primary group (single-level AxiaLIF with PLF) and secondary group (AxiaLIF without PLF and surgeries involving levels other than L5-S1)

    Primary group (n = 28)Secondary group (n = 13)
    Operative time (min)125.2 (72–212)157.0 (59–307)
    Interbody blood loss (mL)28.3 (10–100)30.8 (10–100)
    Posterior blood loss (mL)36.0 (10–150)116.3 (10–400)
    Length of stay (d)1.6 (0–13*)1.7 ( 1–3)
    • NOTE. Values provided are mean (range).

    • ↵* Length of stay was extended for patient with rectal tear; otherwise, the mean was 1.2 days, with a range from 0 to 3 days.

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International Journal of Spine Surgery
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1 Jan 2012
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Minimally invasive trans-sacral approach to L5-S1 interbody fusion: Preliminary results from 1 center and review of the literature
W. Daniel Bradley, Michael S. Hisey, Sunita Verma-Kurvari, Donna D. Ohnmeiss
International Journal of Spine Surgery Jan 2012, 6 110-114; DOI: 10.1016/j.ijsp.2011.12.005

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Minimally invasive trans-sacral approach to L5-S1 interbody fusion: Preliminary results from 1 center and review of the literature
W. Daniel Bradley, Michael S. Hisey, Sunita Verma-Kurvari, Donna D. Ohnmeiss
International Journal of Spine Surgery Jan 2012, 6 110-114; DOI: 10.1016/j.ijsp.2011.12.005
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Keywords

  • Trans-sacral approach
  • clinical outcome
  • interbody fusion
  • lumbar spine
  • review

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