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Revision strategies for AxiaLIF

机译：AxiaLIF的修订策略

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Object: Paracoccygeal transsacral fixation is a novel percutaneous technique for arthrodesis of L5-S1 and L4-5 (Axial Lumbar Interbody Fusion [AxiaLIF]). There are no reports on feasible revision strategies. The goal of this paper is to analyze the surgical details of failed AxiaLIF constructs and to describe revision strategies. Methods: The medical charts, operative records, and imaging studies of 5 patients with failed multisegment instrumentation using the AxiaLIF device were reviewed. Results: AxiaLIF constructs were revised in 5 patients with a mean age of 58.4 years. All AxiaLIF devices were part of multisegment fusion constructs for revision surgery and were revised an average of 15 months after implantation. Two AxiaLIF devices were percutaneously retrieved; one because of excessive bone resorption around the AxiaLIF screw, and the other because of chronic hardware infection. In these 2 patients, the anterior column was subsequently stabilized via anterior lumbar interbody fusion. In the other 3 patients, the AxiaLIF device was left in situ. In 2 of these patients the anterior column was stabilized with bilateral L5- S1 posterior lumbar interbody fusion, and in the remaining patient with L4-5 instability the posterior instrumentation only was revised. Revision surgeries were well tolerated. One patient suffered from a wound dehiscence of the back wound. Conclusions: AxiaLIF devices are safely retrieved using percutaneous technique. Both anterior and posterior revision strategies may be used to achieve anterior column fixation.
机译：目的：co旁经trans固定术是一种用于L5-S1和L4-5关节固定术的新型经皮技术（轴向腰椎椎间融合术[AxiaLIF]）。没有关于可行的修订策略的报告。本文的目的是分析失败的AxiaLIF构建体的手术细节并描述修订策略。方法：回顾了使用AxiaLIF设备对5例多段器械失败的患者的病历，手术记录和影像学研究。结果：5例患者的AxiaLIF构建进行了修订，平均年龄为58.4岁。所有的AxiaLIF设备都是用于翻修手术的多节融合结构的一部分，并且在植入后平均15个月进行了翻修。经皮取出两个AxiaLIF设备;一种是由于AxiaLIF螺钉周围的骨吸收过多，另一种是由于慢性硬件感染。在这2例患者中，随后通过前路腰椎椎间融合器稳定了前柱。在其他3例患者中，AxiaLIF设备留在原位。其中2例患者的前柱通过双侧L5-S1后腰椎椎体间融合术得以稳定，而其余4例L4-5不稳定的患者仅改良了后器械。修订手术耐受性良好。一名患者的背部伤口开裂。结论：AxiaLIF设备可使用经皮技术安全地取出。前后翻修策略均可用于实现前柱固定。

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