Presacral Fusion for Adult Spondylolisthesis
Low-grade spondylolisthesis has been traditionally treated with decompressive laminectomy and posterolateral, interbody fusion, or a combination of both. The combination of an axial presacral approach combined with percutaneous pedicle screw fixation for lumbosacral discectomy and fusion offers a minimally invasive alternative procedure for the surgical management of low-grade lumbosacral spondylolisthesis. This chapter elucidates the anatomy of the presacral space, the biomechanics of presacral axial fusion, and the technique of the axial presacral approach in treating low-grade spondylolisthesis. In addition, we have also highlighted the possible pitfalls and steps to avoid complications at each step of the procedure.
KeywordsAxial construct Presacral Waldeyer’s fascia Spondylolisthesis Percutaneous
- 6.Tender GC, Miller LE, Block JE. Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: a case series. J Med Case Rep. 2011;5:454. PMID: 21910878. PMCID: 3179763.Google Scholar
- 11.Fleischer GD, Kim YJ, Ferrara LA, Freeman AL, Boachie-Adjei O. Biomechanical analysis of sacral screw strain and range of motion in long posterior spinal fixation constructs: effects of lumbosacral fixation strategies in reducing sacral screw strains. Spine. 2012;37(3):E163–9. PMID: 21857409.CrossRefPubMedGoogle Scholar