Last week, ABC World News did a special on the new spinal fusion technique, AxiaLIF. The surgery is less “invasive” than conventional fusion, but can only be performed on the lower part of the spine. Interestingly, the surgeon is not actually able to see the spine- instead, frequent X-rays inform the surgeon of his/her exact location. The ABC special bragged that this new surgery will have patients in and walking out in less than 4 hours. Sounds like magic…
Unfortunately, the special didn’t discuss some of the concerns with AxiaLIF or with spinal fusion in general. Fusions are not magical medical cures. A small population may need fusion procedures, but it’s likely that for the majority of patients, the procedure is providing no benefits at all and potentially causing more problems as result of the surgery.
A few concerns…
AxiaLIF is manufactured by TRANS1. TRANS1 was founded by Dr. Andrew Cragg:
Looks like Dr. Cragg won the bet with his brother, but there are some issues here… If you look into the research for AxiaLIF, you’ll see a common author in the studies: A Cragg. I’m sure Dr. Cragg is a smart dude, but I’m concerned that the man who patented the approach and the owner of the company is also conducting most of the research. Of course he wants AxiaLIF to look great- he’s got investors and a business to protect. Truth is, there needs to be more independent research on AxiaLIF before it can have any bragging rights.
A June 2007 study on AxiaLIF voiced an important concern:
“The anterior minimally invasive procedures are often associated with significantly greater incidence of complications and technical difficulty than their associated open approaches. There is a steep learning curve associated with minimally invasive techniques, and surgeons should not expect to master them in the first several cases.“
So…
Basically, it’s a bad idea to be the first or last person to try out a new surgery. Especially for a surgery that occurs way too often (fusion surgery) and is not backed up by substantial evidence (where’s the solid evidence that it’s better than non-surgical options for most adults?).
Sites to check out:
NBC tells a different story on back pain…
Health News Review grades this ABC special (and provides info about fusion)
I had this procedure done and agree 100% with ABC’s networked special. I suffered several years of back pain with no results until I was operated on using the AxiaLIF procedure. I have and will continue to tell as many as my friends that may have the same issues as I had to look into this.
Nothing upsets me more when I see websites like this trying to “poo poo” a great medical option. I bet you’re not even a doctor.
I am very happy that you found success with AxiaLIF. And you’re right, I’m not a doctor!
Here’s the point (see link in article):
“The anterior minimally invasive procedures are often associated with significantly greater incidence of complications and technical difficulty than their associated open approaches. There is a steep learning curve associated with minimally invasive techniques, and surgeons should not expect to master them in the first several cases.“ (Eck, Hodges & Humphreys, 2007)
This is a big deal. Seiously. Just because something is new and shiny doesn’t mean it’s better. However, if it is belived to be better, then great. But let’s see the evidence to back it up. It’s important that individuals know the risks and benefits and not walk blindly into treatments because their doctor tells them to.
Funny, I visit this site because you “poo poo” on the care/treatments/nutrition that gets shoved down our throats everyday. I appreciate that you look at it all through a different viewpoint. There are too many narrow-minded robots that just follow what the “experts” say. We need more people like you to challenge this stuff and make people think. I like your style too, it’s not about telling people what’s “right” or “true” but it’s about thinking about things differently and questioning conventional thought. Honoring intuition, history, research, ancient healing, technology, etc.
Brian…please give more informatin about post-surgery. Pain? Mobility? etc. This information is hard to find.
I would also like to know more about post surgery…. Aimee, I am sure is not a doctor, and is right to some degree this is not the end all cure all to spinal fusion, but I also wouldn’t let a 12 yr old with his first set of tools operate on me either. For me, someone who wants kids (cant go thru the front) and also a bodybuilder (doctors can’t go thru the back, to much muscle)…this is my ONLY option. So IF YOU GO TO THE BEST DOCTOR who has done a ton of axialif operations, I am sure my chances of improvement will be much greater.
when you have 2 disc that are completely gone in your back aimee, you wont be so quick to knock a operation, instead you will be trying to keep your hopes up, instead of practicly being in a wheelchair at 32 yrs old.
Pete,
I cannot even begin to imagine the pain that you must be in. Back injuries can impact so many areas of one’s life. Truly wishing you healing in every way.
And you’re exactly right in your comment. You are the perfect example of what people should do. You’ve explored your options, considered your unique situation and done your research. And ultimately, you will create a treatment plan that you can feel confident about.
Here’s the problem: tons of procedures are sold to the general public as miracles. People buy into the hype and jump into surgeries/medications for a quick fix before they’ve explored other options. But, c’mon Pete, as a bodybuilder and health advocate you know the reasons why the majority of Americans suffer from low back pain. And those individuals should probably explore other options before surgery or narcotics. Obviously, your situation is different.
Further, new procedures/treatments take time to refine. And research needs to be done to understand the limitations, side effects, risks and benefits of the treatment. Of course there are individuals who need treatment ASAP. And that’s when we can simply pray that the treatment is effective and if possible, conduct as much research as we can. Awesome that you realize this and are seeking out an experienced and ethical surgeon (again, you’d be surprised how often this is ignored by patients).
AxiaLIF might just be the perfect solution for you. Whatever you choose, I truly hope that you find relief from pain.
If you think about it…every medical procedure has been “new” at one time or another and each surgery involves a learning curve. Your best bet is to research your surgeon and learn his or her experience with the procedure you are about to have. I agree that just because something is new doesn’t make it better BUT…it doesn’t mean it isn’t better either. Fusions are done every single day and at one time, they were the “new” craze so think about how medicine evolves.
Aimee, I have seen this procedure performed many times and the learning curve is shorter than other MIS procedures. Other MIS procedures require working thru small cannulas along with still discecting muscles, tissue and retracting nerve roots. I have seen patients up walking 2-3 hours later and going home later that day. Think about it, you could have a PLIF TLIF going thru the back with complications of damaging nerve roots,a large scar in your back and a long recovery time because of the muscle being cut. You could go thru the belly and risk cutting major arteries and have a large scar on your belly. Now you can have a small inscion on your rear, that is so small that it will go away once healed, no risk of artery or nerve damage. The post op fusion rates are the same as the conventional ways of performing fusion surgery. So yes this is shiny and better, better for you the patient.
This is long but I thought it would be useful for the readers to see my whole experience laid out.
I’ve had back problems for the last several years. I’m 39. I used to play a lot of sports which I think has caught up with me and contributed to my back problems. I had a herniated disc a few years ago. It was very painful in my lower back and I had major pain down my left leg whenever I sat. After the surgery to fix that issue my back felt much better. I started working out again and playing basketball but after about 6 months of this I was having lower back pain again. I went to my back doctor and he said I had a degenerated disc and needed to have it fused (L4/L5). I was obviously not very happy about that as he described the two ways of fusing were considered major operations. I decided to hold off on the surgery a little bit and then I saw the ABC news special on this new procedure that is minimally evasive. I was pretty excited about it and talked to a buddy of mine who is a medical rep that works with a lot of back doctors. He said he’s heard some good things about it and knows a doctor in Omaha that does that procedure. I did some checking and it looked like he (Dr. Lodhia) was the only one in Omaha that did the procedure.
I met with Dr. Lodhia as I wanted to get a second opinion on my back and learn more about this procedure. He came back with the same recommendation – disc fusion. He explained how his procedure works and it sounded like a great option to me as he’s had quite a bit of experience with it up to that point.
I was still a bit hesitant to do the surgery and tried physical therapy for a couple months but my pain was getting worse – not better even with some pain killers. I decided to have the surgery in Dec 2009 as I was getting to the point where to turn over in bed I had to grab the side of the bed or my wife in order to turn over. The surgery went as expected. Some patients were able to get out in one night but I had to stay two nights as I was unable to pee. When I went home I was able to get around relatively well considering what was done. I had some pain in my right leg but they said that was normal and should go away.
A couple months passed and my back was feeling stronger as I was going to PT once or twice a week and would get ultrasound on the part of my back where it was still sore (the small incision). I was still having pain in my right leg when I lift it up or extend it forward. I went to a specialist who injected some sort of anti-inflammation drug directly into my nerve which did help a little bit but I still had the pain.
I ended up doing a catscan and Dr. Lodhia noticed something shiny in my catscan right in the area where I was having the pain. He didn’t know what it was but it definitely could be causing my pain since it’s right on that nerve. He thought it could be part of the screw broke off but he said that was unlikely.
May 2010 I had another surgery to remove the shiny metal piece in my back. It ends up that it was the tip of the probe used in the Dec 2009 surgery and it had broken off and stuck into my spine. The nerve was rubbing on it every time I lifted my leg. After the surgery I was immediately able to extend my leg up with very minimal pain. Yeah!
It’s now Aug 2010 and my back is feeling the best it has felt in five years. I’ve played a few pickup basketball games and I’m not having much pain in my legs or lower back any more. I’m more sore from being out of shape than because of my back. I still have some tightness in the lower back and some on-going soreness but I have to say I’m very happy I went with this procedure (besides the problem with the tip of course). If I sit too long in one position I do still have numbness in my leg which could be from the tip irritating the nerve.
I am a strong believer in this procedure and would recommend it to anyone else that is able to go through this procedure instead of going through the stomach or back to have the fusion done. The time in the hospital is shorter and your ability to simply move around is much shorter as well. Just make sure your doctor has done quite a few of these already.
Thanks for your comment Dogger. Sounds like you have some great experience in the field. Can you lead me to the studies for the post op fusion rates you’re talking about? I’d love to read ‘em! Thanks
Brian Pick, wow. What a journey you have been on. Thanks for sharing with us. I am so, so happy that you have found relief from your pain. Sounds as though you were very thoughtful in your decisions throughout the entire process. And thank God you got that piece of metal out of your spine! I hope that you experience continued health and healing- and can get back into some pick up games soon!
Hello,
I’m an AxiaLIF patient with an interesting story and it’s not a good one.I am a 41 yr old female who before all this was very physically active in my life.
After 5 years of back pain, pt, injections, pills I opted to have this surgery because there was nothing that helped the pain. I was told by my surgeon I’d be back to work in 2 weeks tops. Sure! Boy, I’d give anything to feel the way I did BEFORE this procedure.
I had surgery Oct. 29, 2009. My first week, I was sore of course, it’s to be expected. A little over a week passed and something was not right. Excruciating pain. I went to my neuro who did the surgery. In order to get there I had to lay in the back of a truck due to all my pain I was unable to sit. As I sat in his office crying my eyes out, he came in. Didn’t look at my incisions, didn’t look at anything at all. I told him “something is wrong!!!”. He shooed me off and said “it’s muscle spasms” Hardly! I know what a spasm feels like, I had them for years. Also, I was taking 2 muscle relaxers ever 4 hours.
From there,I get scheduled for Physical Therapy the following week. I get there, they are evaluating me. After barely moving my foot per the therapists request, I almost passed out from the pain. He immediately said” Oh my, this is a nerve issue”. I have never been the same since 1 week after my surgery.
In the mornings, I can barely get out of bed. I have my pain pills (Tramadol) laying on the night stand so before I even get up, I take them and lay back down for a few minutes before needing to get in the shower. To lift my leg to get in the shower is excruciating. My right leg, right hip,right pelvic,right glute and lower lumbar hurts every minute of every day. Mornings are absolutely the worst. Obviously, some days are worse than others. Besides the constant pain, I also get shooting pains in my hamstrings that will go down into my foot at times.
So to end this, not everyone is happy with this procedure. I was totally misled of this “miraculous” miracle. I wouldn’t recommend this surgery to an enemy. I wouldn’t wish this type of pain on any one. Now, I struggle to get my Pain Dr.’s to understand the amount of pain I’m in. And, OF COURSE, they don’t understand why I’m in this pain. My x-rays look fine, my cat scan 5 months ago looked good. (WHich doesn’t show the nerves). However, I had my chiro take some x-rays of my lower back just last week in hopes something, ANYTHING would show up. The one thing that did show is is that after 10 months, I’ve not fused at all. Good times!
I am glad that some people found relief. I just wish I was one of them.
Oh, LeAnne. I am so, so, so sorry. I can’t imagine the pain you are in and how that must impact your life. Sending thoughts, prayers and healing energy your way.
I want to thank you so much though for sharing your story. It’s important for people to see both sides and consider their own special circumstances. I can guarantee that someone will read your experience and will approach their treatment with more discernment and ultimately more confidence in what they later decide. Thank you for offering that to someone.
I’m sure you’ve been exploring options for pain, but I’ll throw my 2 cents in
Some ideas: There is quite a bit of research to support the practice of MBSR for pain– especially back pain. Energy healing might bring a bit of relief because it is so gentle and practiced off the body. A highly skilled acupuncturist might be able to relieve a bit of the overall pain. You may want to try and find a PT who integrates yoga, Feldenkrais or the Alexander technique.
Hello Amy and thanks for your reply.
That is exactly why I wanted to post my personal experience. People need to be aware that people can/do have gotten worse after this. I personally do not feel this is a miracle surgery. Again, I’m so happy for the ones who have found relief. Back pain for people who have never had it is very very debilitating. I do work every day, but have also missed a lot of work due to all of this. I was told disability would be no problem. Im certainly not even considering that. When/if it comes to the point I can no longer walk, I’ll have no option. Until then, I have a family to raise and an employer who needs me. There are so many days I want to stay in bed. I can’t. It’s not even an option for me. They (Pain MANG.) have discussed needing to go in and take this hardware out. That’s not even an option for me. I’d be in financial ruins and living on the streets.
The whole thing is so frustrating, but what do we do> The Pain Mang. center I go to now incorporates all that you spoke of above. I did get an accupuncture nerve block 3 weeks ago that was wonderful but very short lived. I was totally numb for 1 entire day. It was great not feeling that pain even if it was short lived.. LOL
I want to thank you for publishing your concerns on this procedure. I have been trying to find others like me, or any research/evidence of AxiaLIF failure and not having a whole lot of luck. There was a AxiaLIF Facebook page. I made sure to post on it. Seems the page has mysteriously disappeared. There were a few on there like me who had voiced their bad experience. There were also good experiences.
I hope people understand this is not what I signed up for. My life is forever changed and not for the better. I have been told I’ll never be 100% again. Even though nobody seems to know what’s wrong exactly.
Thanks again Amy and good luck to all of you who have had success.