{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:36:53Z","timestamp":1774438613929,"version":"3.50.1"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Axial lumbar interbody fusion (AxiaLIF) is a minimally invasive presacral surgical technique that damages neither the anulus fibrosus nor the anterior or posterior longitudinal ligaments. The technique was initially designed and used for L5\u2013S1 interbody fusions and recently was extended to 2-level fusions (L4\u20135 and L5\u2013S1). Until now, only biomechanical and radiological studies have discussed the feasibility of this new indication, and no clinical study has been published. The purpose of this article is to report results and complications associated with 2-level presacral AxiaLIF with a minimum of 24 months of follow-up.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In this prospective, nonrandomized, single-center study, 27 patients underwent presacral AxiaLIF surgery at the L4\u20135 and L5\u2013S1 levels. Clinical outcomes were assessed using the visual analog scale for back and leg symptoms and the Oswestry Disability Index. Radiographic parameters, such as disc height, segmental lordosis, and bone fusion, were analyzed using radiographs and CT scans. Complications and revision surgeries were recorded as needed. The minimum follow-up was 24 months (up to 72 months).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>There were no intraoperative complications. One major complication was observed: a patient developed septicemia that resolved after proper care. Clinical outcomes scores showed overall improvement in pain and physical function. During follow-up, the following complications were observed in the construct: screw breakage (14.8%), proximal\/distal transsacral rod detachment (11.1%), radiolucency around the transsacral rod (52%), and cephalic rod migration (24%). Disc height gain was reported early after surgery, but at the 24-month follow-up the disc space was diminished in comparison with the preoperative status. Compared with preoperative values, the 24-month results showed loss of segmental lordosis. Only 22% of all treated levels were considered to have solid fusion at the 24-month radiological evaluation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Patients undergoing presacral 2-level AxiaLIF experienced satisfactory short-term clinical outcomes; however, complications were commonly seen on imaging studies obtained 24 months postoperatively. Additional studies are required to better understand the 2-level indications for this technique.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.6.spine11915","type":"journal-article","created":{"date-parts":[[2012,7,17]],"date-time":"2012-07-17T16:12:27Z","timestamp":1342541547000},"page":"187-192","source":"Crossref","is-referenced-by-count":29,"title":["Results and complications after 2-level axial lumbar interbody fusion with a minimum 2-year follow-up"],"prefix":"10.3171","volume":"17","author":[{"given":"Luis","family":"Marchi","sequence":"first","affiliation":[{"name":"Instituto de Patologia da Coluna, Sao Paulo, Brazil; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Instituto de Patologia da Coluna, Sao Paulo, Brazil; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etevaldo","family":"Coutinho","sequence":"additional","affiliation":[{"name":"Instituto de Patologia da Coluna, Sao Paulo, Brazil; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz","family":"Pimenta","sequence":"additional","affiliation":[{"name":"Instituto de Patologia da Coluna, Sao Paulo, Brazil; and"},{"name":"Department of Neurosurgery, University of California, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine11915","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-S1 segment: initial clinical and radiographic experience","volume":"51","author":"Aryan","year":"2008"},{"key":"b2-spine11915","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1097\/00007632-199506020-00014","article-title":"Anterior fresh frozen structural allografts in the thoracic and lumbar spine. 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Clinical article","volume":"15","author":"Lindley","year":"2011"},{"key":"b10-spine11915","series-title":"Chin Med J (Engl)","first-page":"215","article-title":"Is the transsacral axial interbody fusion a candidate surgical approach for fusing both L5\/S1 and L4\/5?","volume":"124","author":"Liu","year":"2011"},{"issue":"1","key":"b11-spine11915","series-title":"Neurosurg Focus","first-page":"E9","article-title":"A novel minimally invasive presacral approach and instrumentation technique for anterior L5-S1 intervertebral discectomy and fusion: technical description and case presentations","volume":"20","author":"Marotta","year":"2006"},{"key":"b12-spine11915","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1296","DOI":"10.1097\/BRS.0b013e31821b3e37","article-title":"Minimally-invasive axial pre-sacral L5-S1 interbody fusion: two-year clinical and radiographic outcomes","volume":"36","author":"Tobler","year":"2011"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/17\/3\/article-p187.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/17\/3\/article-p187.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/17\/3\/article-p187.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:09:32Z","timestamp":1681603772000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/17\/3\/article-p187.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,9]]},"references-count":12,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2012.6.spine11915","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2012,9]]}}}