Trans-sacral Lumbar Interbody Fusion

Posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), and anterior lumbar interbody fusion (ALIF) are some of the most commonly used approaches for fusion of the lumbosacral spine. All of these approaches have certain pitfalls that make them less suitable in certain cases. The trans-sacral approach utilizes a pre-sacral corridor to gain access to the L5–S1 disc space. It offers some advantages over other MIS techniques by reducing disruption of the musculature and minimizing injury to vital neurovascular, abdominal, and pelvic structures. Preservation of the annulus and the anterior longitudinal ligament increases implant and biomechanical stability. Overall, the trans-sacral approach has demonstrated high fusion rates, significant improvement in pain and function, low complication rates, and shorter hospital stays.