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Axial Lumbar Interbody Fusion

What does “Axial Lumbar Interbody Fusion” mean?

    Here is the meaning of each word:

  1. Axial: along the axis of the spine
  2. Lumbar: are of the spine located in the low back
  3. Interbody Fusion: to mend two more Vertebrae together

Altogether, “Axial Lumbar Interbody Fusion” means to mend two or more Vertebrae of the low back together by using a technique which is along the axis of the spine.

What is an Axial Lumbar Interbody Fusion (AxiaLIF)?

An AxiaLIF procedure is a minimally invasive spine procedure which targets the L5/S1 disc by approaching the disc through an area underneath the tailbone. After making a small incision next to the coccyx, instruments are placed underneath the sacrum through the S1 Vertebrae and into the L5/S1 disc. A portion of the L5/S1 disc is removed and filled with bone grafting material for a future fusion. A screw is then used to raise the L5/S1 disc and left in place to connect the L5 and S1 vertebrae together.

Why is an Axial Lumbar Interbody Fusion (AxiaLIF) done?

This procedure is done primarily for advanced Degenerative Disc Disease of the L5/S1 disc. It seeks to stabilize this segment by fusing it.

What is unique about the Axial Lumbar Interbody Fusion (AxiaLIF) procedure?

Compared to most other Lumbar Spine Fusions, it is minimally invasive. This procedure also does not use an approach through the back muscles and other back tissues. Instead it approaches the spine from the tailbone.

Is the Axial Lumbar Interbody Fusion (AxiaLIF) limited to a certain disc in the Spine?

The AxiaLIF procedure can only be performed for the L5/S1 disc.

How is an Axial Lumbar Interbody Fusion (AxiaLIF) procedure done?

  1. An intravenous catheter (IV) is started and antibiotics are given
  2. The patient is taken to the Operating Room.
  3. The patient is placed on the back (supine) and a General Anesthetic is given.
  4. The patient is carefully place on the stomach (prone).
  5. The tailbone area is cleaned with sterile surgical antiseptic solution.
  6. Sterile plastic sheets (drapes) are placed around the surgical site.
  7. The surgeon makes a cut (incision) over the side of the coccyx.
  8. A small metal rod is placed underneath the tailbone and advanced upward until it makes contact with the S1 Vertebra. This is done with the help of an X-Ray machine.
  9. Dilator tubes are placed over the metal rod to widen the area
  10. A larger hollow rod is placed over the dilator tubes, which are withdrawn.
  11. A drill is placed through the larger hollow rod to drill a hole through the S1 Vertebra until it reaches the L5/S1 disc
  12. The core of the L5/S1 disc is removed and bone fusion material placed.
  13. A hole is drilled into the L5 Vertebra and a screw placed across the L5/S1 disc.
  14. By turning the screw, the L5/S1 disc is raised.
  15. The screw is secured
  16. All devices are removed
  17. The patient is carefully turned on their back
  18. The patient is awoken from Anesthesia and brought to the Recovery Area for observation.

How long does it take to perform an Axial Lumbar Interbody Fusion (AxiaLIF) surgery?

An AxiaLIF surgery can take about 1.5-3.0 hours to complete.

What is the recovery from an Axial Lumbar Interbody Fusion (AxiaLIF) like?

Here are some of the steps in the recovery from this procedure:

  1. The patient is usually admitted to the hospital for at least an overnight stay.
  2. A low back brace is sometimes used.
  3. A physical therapist may help with the initial recovery after surgery.
  4. After discharge from the hospital, specific instructions on activity are given. Lifting, bending, and twisting are often limited.
  5. A low back brace will sometimes be recommended for several weeks or more after the surgery.
  6. The cuts (incisions) often take 4-6 weeks to heal depending on the type of Lumbar Fusion surgery.
  7. The surgeon will usually reevaluate the patient within several weeks. Often new X-Rays are taken at that time.
  8. The process of a full spinal fusion to develop may take 6 months to 1 year to complete. This does not mean that a patient would necessarily have pain during that process.

What benefit can patients gain from an Axial Lumbar Interbody Fusion (AxiaLIF)?

The benefit from a Lumbar Fusion depends on the original problem for which the spinal fusion was done for. Here are some possible improvements:

  1. Improved stability of the low back
  2. Improved low back pain after the healing is complete

Even after a complete bone fusion of the spine has occurred, some of the original symptoms may remain. Some patients develop new spine symptoms.