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
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