{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:12:33Z","timestamp":1769922753199,"version":"3.49.0"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:p>The authors report a case of rectal injury, rectocutaneous fistula, and pseudarthrosis after a TranS1 axial lumbar interbody fusion (AxiaLIF) L5\u2013S1 fixation. The TranS1 AxiaLIF procedure is a percutaneous minimally invasive approach to transsacral fusion of the L4\u2013S1 vertebral levels. It is gaining popularity due to the ease of access to the sacrum through the presacral space, which is relatively free from intraabdominal and neurovascular structures.<\/jats:p>\n<jats:p>This 35-year-old man had undergone the procedure for the treatment of degenerative disc disease. The patient subsequently presented with fever, syncope, and foul-smelling gas and bloody drainage from the surgical site. A CT fistulagram and flexible sigmoidoscopy showed evidence of rectocutaneous fistula, which was managed with intravenous antibiotic therapy and bowel rest with total parenteral nutrition. Subsequent studies performed 6 months postoperatively revealed evidence of pseudarthrosis. The patient's rectocutaneous fistula symptoms gradually subsided, but his preoperative back pain recurred prompting a revision of his L5\u2013S1 spinal fusion.<\/jats:p>","DOI":"10.3171\/2013.5.spine11523","type":"journal-article","created":{"date-parts":[[2013,6,21]],"date-time":"2013-06-21T14:30:59Z","timestamp":1371825059000},"page":"197-200","source":"Crossref","is-referenced-by-count":6,"title":["Rectocutaneous fistula and nonunion after TranS1 axial lumbar interbody fusion L5\u2013S1 fixation"],"prefix":"10.3171","volume":"19","author":[{"given":"Geoffrey","family":"Siegel","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Wayne State University, Taylor; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Wayne State University, Taylor; and"},{"name":"Michigan Orthopaedic Specialists, Canton and Dearborn, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rakesh","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Wayne State University, Taylor; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine11523","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":"b2-spine11523","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":"b3-spine11523","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E144","DOI":"10.1097\/BRS.0b013e3181ca7351","article-title":"High rectal injury during trans-1 axial lumbar interbody fusion L5-S1 fixation: a case report","volume":"35","author":"Botolin","year":"2010"},{"key":"b4-spine11523","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":"b5-spine11523","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1016\/j.spinee.2009.08.459","article-title":"A novel alternative for removal of the AxiaLif (TranS1) in the setting of pseudarthrosis of L5-S1","volume":"9","author":"DeVine","year":"2009"},{"key":"b6-spine11523","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":"b7-spine11523","series-title":"Surg Clin North Am","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1016\/S0039-6109(02)00056-7","article-title":"Anorectal anatomy","volume":"82","author":"Kaiser","year":"2002"},{"issue":"1","key":"b8-spine11523","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":"b9-spine11523","series-title":"Clin Anat","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1002\/ca.10129","article-title":"Determination of the width of the presacral space on magnetic resonance imaging","volume":"17","author":"Oto","year":"2004"},{"issue":"5 Suppl","key":"b10-spine11523","series-title":"Neurosurgery","first-page":"S26","article-title":"Review: complications of minimally invasive spinal surgery","volume":"51","author":"Perez-Cruet","year":"2002"},{"issue":"1 Suppl","key":"b11-spine11523","series-title":"J Neurosurg","first-page":"60","article-title":"Visceral and vascular complications resulting from anterior lumbar interbody fusion","volume":"91","author":"Rajaraman","year":"1999"},{"key":"b12-spine11523","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1097\/01.bsd.0000187979.22668.c7","article-title":"Anatomy of the percutaneous presacral space for a novel fusion technique","volume":"19","author":"Yuan","year":"2006"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/19\/2\/article-p197.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/19\/2\/article-p197.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/19\/2\/article-p197.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T23:11:47Z","timestamp":1681600307000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/19\/2\/article-p197.xml"}},"subtitle":["Case report"],"short-title":[],"issued":{"date-parts":[[2013,8]]},"references-count":12,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2013.5.spine11523","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2013,8]]}}}