Paracoccygeal Transsacral Approach: A Rare Approach for Axial Lumbosacral Interbody Fusion

Area of Science:

• Orthopedics
• Neurosurgery
• Spinal Surgery

Background:

• Degenerative spinal pathologies often require lumbosacral interbody fusion for pain and functional impairment.
• Traditional open surgical techniques (ALIF, PLIF, TLIF) are established but associated with significant tissue disruption.
• Minimally invasive spinal surgery aims to reduce tissue damage while maintaining or improving surgical outcomes.

Purpose of the Study:

• To review clinical and biomechanical evidence for the paracoccygeal transsacral approach to axial lumbosacral interbody fusion.
• To evaluate the efficacy, safety, and potential benefits of this minimally invasive technique.
• To discuss surgical considerations for spinal surgeons adopting this novel approach.

Main Methods:

• Extensive literature review of clinical and biomechanical studies on the paracoccygeal transsacral approach.
• Analysis of data regarding fusion rates, pain reduction, functional improvement, and complication rates.
• Synthesis of information on indications, anatomy, contraindications, and technical aspects.

Main Results:

• The paracoccygeal transsacral approach demonstrates high fusion rates.
• Consistent improvements in patient pain and function are reported.
• This technique is associated with reduced perioperative morbidity and a low complication rate.

Conclusions:

• The paracoccygeal transsacral approach is a promising minimally invasive option for lumbosacral interbody fusion.
• Early evidence suggests favorable clinical outcomes and safety profile.
• Further comparative studies are needed to fully establish its role against traditional and other minimally invasive techniques.