Rectocutaneous fistula and nonunion after TranS1 axial lumbar interbody fusion L5–S1 fixation

Siegel, Geoffrey; Patel, Nilesh H.; Ramakrishnan, Rakesh

doi:10.3171/2013.5.spine11523

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…The peer-reviewed published literature reporting outcomes for axial lumbar interbody fusion remains limited to retrospective case series, review articles, and technical reports [20][21][22][23][24][25][26][27][28][29]. To date, there are no randomized controlled trials that support the efficacy and safety of axial lumbar interbody fusion as a minimally invasive or percutaneous surgical procedure for the treatment of L5-S1 conditions.…”

Section: Discussionmentioning

confidence: 99%

Patient Self-Education and the Internet: An Evaluation of the Internet Contents Regarding Axial Lumbar Intervertebral Fusion (AxiaLIF)

Faour¹

2017

OROAJ

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Introduction:The internet has become the main source of information for medical conditions and treatment options. The AxiaLIF system is a novel minimally invasive fusion technique for the treatment of single-level fusion. The evidence to support the efficacy and the safety of the procedure is lacking. Our study aimed to evaluate how accurate and reliable is the information on the internet regarding the AxiaLIF.Methods: Google, Yahoo, and Bing, were used to find the top 105 sites (35 per engine) providing information on AxiaLIF. These sites were then divided into groups based on authorship. Each site was comprehensively analyzed for information about the procedure. Data were collected and evaluated for each authorship subgroup as well as for the entire group of websites.Results: Of the sites examined, 41% were authored by news and public reports group, 33% by private medical groups, 19% by academic medical groups, and 7% by medical industry. All of the websites offered at least one indication for the AxiaLIF. Only 7% of these sites contained contraindications for the procedure. While only 7% of the sites addressed the lack of strong evidence in the literature favoring AxiaLIF over traditional approaches, about one third of the websites claimed that AxiaLIF is an alternative to traditional surgical procedures. Benefits were extensively reported in all the websites, the highest reporting rate was in the industry group with an average of 2.4 per website. In contrast, one or more complications were reported in 74% of all websites. Conclusion:This study demonstrated that the internet is ineffective in comprehensively reporting critically important information for patients regarding the AxiaLIF procedure. Physicians should make efforts to counsel patients regarding the limitations of the information present on the internet.

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Section: Discussionmentioning

confidence: 99%

Patient Self-Education and the Internet: An Evaluation of the Internet Contents Regarding Axial Lumbar Intervertebral Fusion (AxiaLIF)

Faour¹

2017

OROAJ

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“…She went on to develop a nonunion, which was treated with revision posterior spinal fusion and no explantation of the AxiaLIF device. Siegel and colleagues 29 reported on the development of a rectocutaneous fistula in a 35-year-old man after L5-S1 AxiaLIF. The patient presented with sepsis and bloody drainage from the surgical site.…”

Section: Complicationsmentioning

confidence: 99%

“…At 6 months, the patient developed a pseudarthrosis that required surgical revision. 29 Pseudarthrosis is a concern when using the 2-level AxiaLIF procedure. Issack and Boachie-Adjei 15 reported two pseudarthroses in their series: one at L4-5 and the other at L5-S1.…”

Section: Complicationsmentioning

confidence: 99%

The axial transsacral approach to interbody fusion at L5–S1

Issack

Kotwal²,

Boachie-Adjei³

2014

FOC

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Lumbosacral interbody fusion may be indicated to treat degenerative disc disease at L5–S1, instability or spondylolisthesis at that level, and severe neural foraminal stenosis resulting from loss of disc space height. In addition, L5–S1 interbody fusion may provide anterior support to a long posterior fusion construct and help offset the stresses experienced by the distal-most screws. There are 3 well-established techniques for L5–S1 interbody fusion: anterior lumbar interbody fusion, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion. Each of these has advantages and pitfalls. A more recently described axial transsacral technique, utilizing the presacral corridor, may represent a minimally invasive approach to obtaining lumbosacral interbody arthrodesis. Biomechanical studies demonstrate that the stiffness of the axial rod is comparable to existing fixation devices, suggesting that, biomechanically, it may be a good implant for obtaining lumbosacral interbody fusion. Clinical studies have demonstrated good early results with the use of the axial transsacral approach in obtaining lumbosacral interbody fusion for degenerative disc disease, spondylolisthesis, and below long posterior fusion constructs. The technique is exacting and complications can be major, including rectal perforation and fistula, loss of correction, and pseudarthrosis.

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