Abstract | | Paracoccygeal approach to the L5-S1 junction with transsacral instrumentation was described recently as an alternative method to transforaminal lumbar interbody fusion or posterior lumbar interbody fusion. A percutaneous L5-S1 discectomy, interbody distraction, and fixation could be acheived while preserving the integrity of the muscles, ligaments, and disc anulus. Retroperitoneal viscera and dorsal neural elements are avoided via the presacral safe zone. Additional pedicle or facet screw fixation is recommended to provide stabilization and promote fusion. AxiaLIF represents a solid-based fusion technique for degenerative disc disease at L5-S1 level with minimal collateral damage in carefully selected patients.
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