title: Comparison of axial and anterior interbody fusions of the L5-S1 segment: a retrospective cohort analysis.
abstract: METHODS
  Retrospective, multicenter review of 96 patients who underwent L5-S1 interbody fusions through either a standard anterior retroperitoneal approach or using a novel device inserted through the presacral space (AxiaLIF) in conjunction with supplemental posterior fixation between 2002 and 2010.
  
  
  OBJECTIVE
  To compare the radiographic fusion rates and adverse events associated with anterior lumbar interbody fusion (ALIF) and AxiaLIF techniques.
  
  
  BACKGROUND
  Interbody fusions of the lumbosacral spine are frequently performed to provide anterior column support, increase the amount of surface area for bone formation, and facilitate deformity reduction. A number of different surgical approaches have been developed for this purpose including minimally invasive techniques.
  
  
  METHODS
  Patient information and procedural data were obtained from hospital charts. Multiplanar computed tomography images were evaluated by 2 independent observers to assess fusion success at 24 months using a 4-point grading scale. In addition to reviewing the medical records to identify any complications, all of the sites were queried regarding any device-related adverse events that may have occurred.
  
  
  RESULTS
  According to the radiographic analysis, the arthrodesis rates recorded for the ALIF and AxiaLIF cohorts were 79% and 85%, respectively (P>0.05). The numbers and types of adverse events recorded for these procedures appeared to be similar although there was 1 serious intraoperative complication (iliac artery laceration) noted in the ALIF group.
  
  
  CONCLUSIONS
  The radiographic success and adverse events associated with AxiaLIF appear to be similar to that observed for ALIF, suggesting that this technique represents a safe and effective method for achieving an interbody fusion across the L5-S1 disk space when utilized in conjunction with posterior fixation.
authors.affiliation: *Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT †Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN ‡Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, CO §Department of Orthopaedic and Spine Surgery, St Jude Heritage Medical Group, Fullerton, CA ∥Department of Orthopaedic Surgery, Oakland University School of Medicine, William Beaumont Hospital, Royal Oak, MI.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Whang
authors.forename: Rick C
authors.initials: RC
authors.lastname: Sasso
authors.forename: Vikas V
authors.initials: VV
authors.lastname: Patel
authors.forename: Raed M
authors.initials: RM
authors.lastname: Ali
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Fischgrund
mesh_terms: D000328:Adult; D000368:Aged; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000601:surgery*; D003710:Demography; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome