Surgical techniques for lumbo-sacral fusion - 08/02/17

Doi : 10.1016/j.otsr.2016.06.023

P. Tropiano ^a,^b,^⁎ , H. Giorgi ^a, A. Faure ^a, B. Blondel ^a
^a Service de chirurgie orthopédique et vertébrale, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France
^b Orthopaedic and spine surgery department, Aix-Marseille Université, Marseille school of medicine, Marseille teaching hospital network (AP–HM), institute for research into non-equilibrium phenomena (IRPHE), 13013 Marseille, France

^⁎Corresponding author. Service de chirurgie orthopédique et vertébrale, hôpital de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France.

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Abstract

Lumbo-sacral (L5-S1) fusion is a widely performed procedure that has become the reference standard treatment for refractory low back pain. L5-S1 is a complex transition zone between the mobile lordotic distal lumbar spine and the fixed sacral region. The goal is to immobilise the lumbo-sacral junction in order to relieve pain originating from this site. Apart from achieving inter-vertebral fusion, the main challenge lies in the preoperative determination of the fixed L5-S1 position that will be optimal for the patient. Many lumbo-sacral fusion techniques are available. Stabilisation can be achieved using various methods. An anterior, posterior, or combined approach may be used. Recently developed minimally invasive techniques are gaining in popularity based on their good clinical outcomes and high fusion rates. The objective of this conference is to resolve the main issues faced by spinal surgeons in their everyday practice.

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Keywords : Spinal fusion, Arthrodesis, Anterior lumbar interbody fusion (ALIF), Posterior lumbar interbody fusion (PLIF), Transforaminal lumbar interbody fusion (TLIF), Lordosis