Axial lumbar interbody fusion: a 6-year single-center experience

Figures & data

Figure 1 The AxiaLIF rod.

Note: 50 mm length shown.
Abbreviation: AxiaLIF, axial lumbar interbody fusion.

Figure 2 Presacral access with the AxiaLIF system.

Notes: Dilator and guide pin advanced into the L5–S1 interspace (A). Radial cutters debulking disc material and preparing the endplates for fusion (B). Insertion of bone graft material in the L5–S1 interspace (C). AxiaLIF rod implantation to within 5–10 mm of superior endplate of L5 (D). Images provided courtesy of Baxano surgical, Inc.³²
Abbreviation: AxiaLIF, axial lumbar interbody fusion.

Table 1 Baseline patient characteristics

Variable	Values (n = 131)
Demographics
Female sex, n (%)	88 (67)
Age, mean ± SD, years	41 ± 8
Body mass index, mean ± SD, kg/m^2	26 ± 4
Smoking history, n (%)
Never	49 (37)
Former	40 (31)
Current	42 (32)
Medical history
Disc height, mean ± SD	5.5 ± 1.8
Disc height, mean ± SD, % relative to L4–L5	52 ± 18
Back pain duration, mean ± SD, months	59 ± 54
Previous back surgery, n (%)	8 (6)
Symptom severity
Back pain severity, mean ± SD	79 ± 12
Leg pain severity, mean ± SD	45 ± 30
Oswestry Disability Index, mean ± SD	46 ± 16

Abbreviations: n, number; SD, standard deviation.

Table 2 Univariate baseline predictors of solid fusion at final postoperative follow-up

Variable	P-value
Sex	<0.01
Bone graft type	0.13
Back pain duration	0.16
Work status	0.17
Disc height % (relative to L4–L5)	0.20
Back pain severity	0.21
Body mass index	0.35
Posterior facet screw fixation	0.44
Age	0.53
Smoking history	0.71
Back function	0.85
Leg pain severity	0.91

Figure 3 Preoperative T1 (A) and T2 (B) images of a 34-year-old woman with a 6-year history of back pain showing discopathy at the L5/S1 level with Modic 1 endplate changes. Postoperative sagittal (C) and coronal (D) CT at 1 year demonstrates solid fusion.

Abbreviation: CT, computed tomography.

Table 3 Comparison of studies with axial lumbar interbody fusion for degenerative disc disease

Study	N	Mean follow-up (months)	Improvement (%)				Fusion (%)	Other
			Back pain	Leg pain	ODI	CT	X-ray
Tobler et al^Citation13	156	24	63	–	54	–	–	94*
Current series	131	21	51	42	50	88	–	–
Gerszten et al^Citation14	99	24	67	–	56	94	–	–
Lindley et al^Citation17	68	34	–	–	–	–	100	91**
Bohinski et al^Citation15	50	12	49	–	50	88	96	–
Patil et al^Citation18	50	12	56	–	52	–	–	–

Notes: Axial lumbar interbody fusion studies with primary diagnosis of degenerative disc disease, ≥50 patients and ≥1-year mean follow-up.

* Radiograph (57%), CT (43%).

** imaging modality (CT or X-ray) unclear.

Abbreviations: N, number; ODI, Oswestry Disability Index; CT, computed tomography.

AxiaLIF [patient literature]Raleigh, NCBaxano Surgical, Inc2013

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