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New Percutaneous Access Method for Minimally Invasive Anterior Lumbosacral Surgery

Cragg, Andrew MD; Carl, Allen MD*; Casteneda, Flavio MD; Dickman, Curtis MD; Guterman, Lee MD, PhD§; Oliveira, Carlos MD

Journal of Spinal Disorders & Techniques: February 2004 - Volume 17 - Issue 1 - p 21-28
Original Article

Preliminary cadaver, animal, and human studies were performed to determine the feasibility of axial anterior lumbosacral spine access using a percutaneous, presacral approach. Custom instruments were directed under fluoroscopic guidance along the midline of the anterior sacrum to the surface of the sacral promontory where an axial bore was created into the lower lumbar vertebral bodies and discs. Imaging and gross dissection were performed in cadavers and animals. The procedure was used for lumbosacral biopsy in human subjects guided by intraoperative imaging and clinical monitoring. All procedures were technically successful. This study demonstrates the feasibility of the axial access technique to the anterior lower lumbar spine.

From the University of Minnesota, Minneapolis, Minnesota, *Albany Medical College, Albany, New York, †University of Illinois, Peoria, Illinois, ‡Barrow Neurological Institute, Phoenix, Arizona, and §State University of New York, Buffalo, New York, and ¶Hospital do Servidor Estadual, Sao Paulo, Brazil

Received for publication February 13, 2003; accepted April 18, 2003.

Reprints: Dr. Andrew Cragg, 4502 Edina Blvd., Edina, MN 55424 (

Supported by TranS1, Inc.

© 2004 Lippincott Williams & Wilkins, Inc.