E-Case report

Multiple Trauma T9, T10, T12
Posterior fixation T8 – L1
Daniel Mahr, MD
Daniel Popp, MD, PD

Pre OP

Clinical Case – Multiple Trauma Fractures T9, T10 and T12
Posterior fixation T8 – L1
Neo ADVISE™ -Fixation module, 3D scanning

Dr. Daniel Mahr
PD Dr. Daniel Popp
Orthopaedic/Trauma Surgeons
Universitätsklinikum Regensburg
Regensburg, Germany

Dr. Daniel Mahr

PD Dr. Daniel Popp

Patient Information

36-year-old male patient suffered severe cranial brain trauma and multiple vertebral fractures when he fell from a great height at his workplace

  • Low impact fractures T9, T10 and T12
  • Partly unstable fractures
  • Skull surgery was performed a few days prior to the planned spine surgery
  • Good bone quality
  • Neurological status unknown

Planned Surgery:

  1. General anesthesia – ITN & TIVA
  2. Patient in prone position
  3. Mini-open surgery, percutaneous lateral approach
  4. Posterior fixation T8 – L1
  5. In situ fixation
  6. Neo ADVISE™ 3D scanning

Pre OP images, sagittal & axial views at the levels of the planned implant placements

marco grosso pre operation representation
marco grosso pre operation representation
marco grosso pre operation representation
marco grosso pre operation representation

Intra OP

Access and K-wires placement

marco grosso pre operation representation
marco grosso pre operation representation

Pedicle screws insertion

Posterior fixation with Neo Pedicle Screw System™

Totally 8 pedicle screws were placed over the levels T8 – L1

  • T8 – 2 x Ø5.0x45 mm polyaxial
  • T9 – 2 x Ø6.0x50 mm polyaxial
  • T11 – 2 x Ø6.0x50 mm polyaxial
  • L1 – 2 x Ø7.0x45 mm polyaxial

Video is showing all steps using Neo ADVISE™ fixation module in the left side of the spine

Visualizations of the left side rod in both the sagittal and the coronal planes in the iPad screen as a result from Neo ADVISE™ , and for the coronal plane with or without rod smoothing

Sagittal plane

Coronal plane,
Rod smoothing OFF

Coronal plane,
Rod smoothing ON

Rod Smoothing

On the Coronal plane, the poly-axiality of the screws is taken into account

Rod placement

2 x Titanium rods 200mm straight, shortened to 180mm right rod, and 190mm left rod

marco grosso pre operation representation

Radiographs after the final fixation of the posterior construction, removal of the instrumentation, and incisions sutured

Post OP

Post OP radiographs at discharge from the hospital

  • Blood loss: 250 ml
  • Duration of surgery: 180 min

Published with the approval of Dr. Daniel Mahr & Dr. Daniel Popp