{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T09:00:50Z","timestamp":1780736450032,"version":"3.54.1"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Paracoccygeal transsacral fixation is a novel percutaneous technique for arthrodesis of L5\u2013S1 and L4\u20135 (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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The medical charts, operative records, and imaging studies of 5 patients with failed multisegment instrumentation using the AxiaLIF device were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2013S1 posterior lumbar interbody fusion, and in the remaining patient with L4\u20135 instability the posterior instrumentation only was revised. Revision surgeries were well tolerated. One patient suffered from a wound dehiscence of the back wound.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AxiaLIF devices are safely retrieved using percutaneous technique. Both anterior and posterior revision strategies may be used to achieve anterior column fixation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2011.8.focus11139","type":"journal-article","created":{"date-parts":[[2011,9,30]],"date-time":"2011-09-30T13:13:31Z","timestamp":1317388411000},"page":"E17","source":"Crossref","is-referenced-by-count":11,"title":["Revision strategies for AxiaLIF"],"prefix":"10.3171","volume":"31","author":[{"given":"Christoph P.","family":"Hofstetter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"James","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"H\u00e4rtl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1097\/00007632-199404150-00014","article-title":"Anular incision technique on the strength and multidirectional flexibility of the healing intervertebral disc","volume":"19","author":"Ahlgren","year":"1994"},{"key":"b2-0310017","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1097\/BSD.0b013e3180577242","article-title":"Biomechanical evaluation of paracoccygeal transsacral fixation","volume":"21","author":"Akesen","year":"2008"},{"key":"b3-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E54","DOI":"10.1097\/BRS.0b013e3181918aae","article-title":"Posterior migration of fusion cages in degenerative lumbar disease treated with transforaminal lumbar interbody fusion: a report of three patients","volume":"34","author":"Aoki","year":"2009"},{"key":"b4-0310017","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1055\/s-2008-1080915","article-title":"Percutaneous axial lumbar interbody fusion (AxiaLIF) of the L5\u2013S1 segment: initial clinical and radiographic experience","volume":"51","author":"Aryan","year":"2008"},{"key":"b5-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1846","DOI":"10.1097\/01.brs.0000174275.95104.12","article-title":"In vitro, biomechanical comparison of an anterior lumbar interbody fusion with an anteriorly placed, low-profile lumbar plate and posteriorly placed pedicle screws or translaminar screws","volume":"30","author":"Beaubien","year":"2005"},{"key":"b6-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1097\/00007632-199405310-00014","article-title":"Pseudarthrosis rate after allograft posterior lumbar interbody fusion with pedicle screw and plate fixation","volume":"19","author":"Brantigan","year":"1994"},{"issue":"157","key":"b7-0310017","series-title":"Clin Orthop Relat Res","first-page":"191","article-title":"Causes of failure of surgery on the lumbar spine","author":"Burton","year":"1981"},{"key":"b8-0310017","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1097\/00024720-200402000-00006","article-title":"New percutaneous access method for minimally invasive anterior lumbosacral surgery","volume":"17","author":"Cragg","year":"2004"},{"key":"b9-0310017","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1007\/s00586-009-0953-5","article-title":"Biomechanical evaluation of a new AxiaLIF technique for two-level lumbar fusion","volume":"18","author":"Erkan","year":"2009"},{"key":"b10-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1097\/00007632-198001000-00015","article-title":"Analysis of failures and poor results of lumbar spine surgery","volume":"5","author":"Fager","year":"1980"},{"key":"b11-0310017","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.spinee.2006.05.015","article-title":"Revision open anterior approaches for spine procedures","volume":"7","author":"Gumbs","year":"2007"},{"key":"b12-0310017","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1055\/s-0029-1239504","article-title":"Neuronavigation in the minimally invasive presacral approach for lumbosacral fusion","volume":"52","author":"Luther","year":"2009"},{"key":"b13-0310017","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"675","DOI":"10.2106\/00004623-197456040-00003","article-title":"The structural components of the intervertebral disc. A study of their contributions to the ability of the disc to withstand compressive forces","volume":"56","author":"Markolf","year":"1974"},{"key":"b14-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00007632-199401000-00001","article-title":"The infra-aortic arteries of the spine: their variability and clinical significance","volume":"19","author":"Parke","year":"1994"},{"key":"b15-0310017","series-title":"Spine (Phila Pa 1976)","article-title":"Minimally-invasive axial pre-sacral L5-S1 interbody fusion: two year clinical and radiographic outcomes","author":"Tobler","year":"2011"},{"key":"b16-0310017","series-title":"J Surg Orthop Adv","first-page":"200","article-title":"Salvage procedures for pseudarthrosis after transforaminal lumbar interbody fusion (TLIF)-anterior-only versus anterior-posterior surgery: a clinical and radiological outcome study","volume":"18","author":"Vargas-Soto","year":"2009"},{"key":"b1-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1097\/00007632-199404150-00014","article-title":"Anular incision technique on the strength and multidirectional flexibility of the healing intervertebral disc","volume":"19","author":"Ahlgren","year":"1994"},{"key":"b2-0310017","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1097\/BSD.0b013e3180577242","article-title":"Biomechanical evaluation of paracoccygeal transsacral fixation","volume":"21","author":"Akesen","year":"2008"},{"key":"b3-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E54","DOI":"10.1097\/BRS.0b013e3181918aae","article-title":"Posterior migration of fusion cages in degenerative lumbar disease treated with transforaminal lumbar interbody fusion: a report of three patients","volume":"34","author":"Aoki","year":"2009"},{"key":"b4-0310017","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1055\/s-2008-1080915","article-title":"Percutaneous axial lumbar interbody fusion (AxiaLIF) of the L5\u2013S1 segment: initial clinical and radiographic experience","volume":"51","author":"Aryan","year":"2008"},{"key":"b5-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1846","DOI":"10.1097\/01.brs.0000174275.95104.12","article-title":"In vitro, biomechanical comparison of an anterior lumbar interbody fusion with an anteriorly placed, low-profile lumbar plate and posteriorly placed pedicle screws or translaminar screws","volume":"30","author":"Beaubien","year":"2005"},{"key":"b6-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1097\/00007632-199405310-00014","article-title":"Pseudarthrosis rate after allograft posterior lumbar interbody fusion with pedicle screw and plate fixation","volume":"19","author":"Brantigan","year":"1994"},{"issue":"157","key":"b7-0310017","series-title":"Clin Orthop Relat Res","first-page":"191","article-title":"Causes of failure of surgery on the lumbar spine","author":"Burton","year":"1981"},{"key":"b8-0310017","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1097\/00024720-200402000-00006","article-title":"New percutaneous access method for minimally invasive anterior lumbosacral surgery","volume":"17","author":"Cragg","year":"2004"},{"key":"b9-0310017","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1007\/s00586-009-0953-5","article-title":"Biomechanical evaluation of a new AxiaLIF technique for two-level lumbar fusion","volume":"18","author":"Erkan","year":"2009"},{"key":"b10-0310017","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1097\/00007632-198001000-00015","article-title":"Analysis of failures and poor results of lumbar spine surgery","volume":"5","author":"Fager","year":"1980"},{"key":"b11-0310017","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.spinee.2006.05.015","article-title":"Revision open anterior approaches for spine procedures","volume":"7","author":"Gumbs","year":"2007"},{"key":"b12-0310017","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1055\/s-0029-1239504","article-title":"Neuronavigation in the minimally invasive presacral approach for lumbosacral fusion","volume":"52","author":"Luther","year":"2009"},{"key":"b13-0310017","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"675","DOI":"10.2106\/00004623-197456040-00003","article-title":"The structural components of the intervertebral disc. 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