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Revision strategies for AxiaLIF
Christoph P Hofstetter1, Andrew R James, Roger Härtl
1Department of Neurological Surgery and Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York 10065, USA.
Neurosurgical Focus
|October 4, 2011
Summary
Revision strategies for failed Axial Lumbar Interbody Fusion (AxiaLIF) were analyzed. Percutaneous removal of AxiaLIF devices is safe, and both anterior and posterior approaches can stabilize the spine during revision surgery.
Area of Science:
- Spine surgery
- Minimally invasive techniques
- Orthopedic surgery
Background:
- Axial Lumbar Interbody Fusion (AxiaLIF) is a percutaneous technique for L5-S1 and L4-5 arthrodesis.
- Limited data exists on revision strategies for failed AxiaLIF constructs.
Observation:
- This study reviewed 5 patients with failed multisegment AxiaLIF instrumentation.
- Mean patient age was 58.4 years, with revisions occurring 15 months post-implantation.
- Reasons for revision included screw loosening and hardware infection.
Findings:
- Two AxiaLIF devices were percutaneously retrieved and anterior lumbar interbody fusion was performed.
- In three patients, the AxiaLIF remained in situ, with anterior or posterior lumbar interbody fusion addressing instability.
- Revision surgeries were generally well-tolerated, with one instance of wound dehiscence.
Implications:
- Percutaneous retrieval of AxiaLIF devices is a safe and feasible option.
- Both anterior and posterior surgical strategies can effectively achieve anterior column fixation in AxiaLIF revisions.
- This study provides valuable insights into managing failed AxiaLIF cases.
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