The Presacral Approach (AxiaLIF)

  • John Gachiani
  • Silvia Gesheva
  • Mihaela Florea
  • Gabriel Tender


The presacral approach (AxiaLIF) offers a minimally invasive fusion option for the L5-S1 (or the L4-L5 and L5-S1) discs, taking advantage of the presacral space and transsacral trajectory. Supplemental posterior stabilization with either percutaneous facet or pedicle screws is indicated, in order to limit rotation. This technique is particularly useful in patients with low-grade spondylolisthesis, after reduction with the percutaneous pedicle screws, and in patients with collapsed discs following a previous laminectomy and discectomy.

Supplementary material

Video 10.1

AxiaLIF with facet screws (MP4 95905 kb)


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • John Gachiani
    • 1
  • Silvia Gesheva
    • 2
  • Mihaela Florea
    • 3
  • Gabriel Tender
    • 4
  1. 1.Mercy NeurosurgeryDes MoinesUSA
  2. 2.Department of NeurosurgeryLouisiana State University Health Sciences CenterNew OrleansUSA
  3. 3.Department of Neurosurgery“Bagdasar-Arseni” HospitalBucharestRomania
  4. 4.Louisiana State UniversityNew OrleansUSA

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