I had L5/S1 Axialif on Dec 4 09
I'm posting this thread because it appears there is not alot of information out there regarding the Axialif Procedure.
When I first considered this procedure I spent alot of time researching but was unable to find any patient accounts. Since then I have had the Axialif procedure at L5/S1 on Dec 4 09.
This procedure was indicated for me due to an unstable spondylolisthesis at L5/S1 including DDD and spinal stenosis which both go hand and hand with the spondyolisthesis.
To begin, their is not alot of information out there because of the way this procedure is coded. Often, the patient does not even know they are having an Axialif but instead just a new innovative procedure. The procedure is often coded under an anterior inter-body fusion as many insurances wont pay for the Axialif because it is still considered experimental.
Some things to consider:
This procedure is minimally invasive which allows for quicker recovery and less trauma to soft tissue including the very important Multifidi muscles.
This procedure is indicated for patients with spondyloisthesis and/ or Degenerative Disk Disease in which the disk height is lost.
The Trans 1 rod can now be installed to L4/L5 and L5/S1.
The rod has the ability to increase disk space.
It is very important that the surgeon adds posterior screws such as Facet or pedicle screws!! This will help to ensure fusion!
It is very important the surgeon has done more than 1 or 2 of these procedures as minimally invasive surgery has a steep learning curve. (I personally called the Trans 1 rep in my area and asked which surgeons had done alot)
As with any surgery there can be complications: Including infection, loosening hardware, malunion (non-fusion), perforated bowel, nerve damage.
My surgery went fairly well;
I was out of the hospital in 24 hours.
I had pretty severe pain from the placement of the 4 pedicle screws which were done with small incisions. I feel this was due to the trauma of stretching the soft tissue. The severe pain lasted 1 week.
I ended up with a hospital aquired infection (pseudomonas) which took 3 weeks antibiotics. The infection was in one of the pedicle screw incisions.
My symptoms of LB pain diminished quickly but my neurological symptoms in my Lower extremities did not. The neuro symptoms continue to be a problem but have diminshed 75%. This may take longer to heal as there are some factors here; For one, periphereal nerves heal very slowly (about 1mm per day), secondly the Trans 1 screw increases the disk height which may place a traction on nerve thus injuring it more. Thirdly, many patients seek relief from these symptoms but these symptoms may be coming from elsewhere such as SI joint, other Lumbar levels, piriformis muscle, tight hamstrings etc.
After the surgery it is important to wear a brace and to avoid bending, lifting or twisting for 3 months. This is very important!
Therefore, working is out of the question if it involves bending, lifting or twisting. Taking off from work for atleast 4 weeks is what I would recommend. I went back to work after two weeks ( 3 days per week) I am a licensed Physical Therapist and have been working for years with an unstable back so for me it was easy to follow the above rules. However, I do not recommend this.
If considering this procedure do the following:
1. go to trans 1 web site for physicians and watch entire surgery.
2. Find an experienced surgeon in your area that has done many of these and seek 2 or 3 second opinions.
3. Try Physical Therapy and epidural injections prior to surgery.
4. If you proceed with surgery dont be misled in thinking you wont need time top recover, You will!
5. Follow the rules of no bending lifting or twisting for atleast three months.
6. Wear your brace.
7. Smokers should quit since smoking prevents fusion in some cases.
8. If your surgeon will allow; start a neutral spinal stabilization program following procedure; walk often.
Good luck and I hope this helps to fill in the gaps regarding the Trans 1 Axialif procedure.