E-Case report

DDD, Degenerative Disc Disease
Spinal Fusion L2 – S1Konstantinos Kafchitsas, MD PD

Pre OP

Clinical Case – Degenerative Disc Disease
Spinal Fusion L2 – S1
Neo ADVISE™

PD Dr. Konstantinos Kafchitsas
Asklepios Klinik Lindenlohe
Schwandorf
Germany

Patient Information:

83-year-old female patient with degenerative disc disease in lumbar region

Pain therapy at home resulted in no improvement

Diagnosed with:

L3-4 spondylarthrosis
L4-5 olisthesis with spinal canal stenosis, osteochondrosis
L5- S1 lumboischialgia on the right side, and slowly develloping also on the left side
- Limping gait pattern
- Percussion pain deep lumbar over the spinous processes
- Positive facet compression test of the lumbar spine
- Lasègue’s sign positive on both sides from 30°
- No sensory motor deficit in any side
- Acute hemolytic anemia
- Postmenopausal osteoporosis
- Urinary tract infection
- Hip joint prosthesis left side

Planned Surgery:

General anesthesia
Open surgery, midline access
PLIF expandable cages L2/3, L4/5, L5/S1
Decompression L2/3, L4/5
Posterior fixation L2 – S1
Neo ADVISE™ 3D scanning

Pre OP standing radiographs & MRI, frontal and sagittal views.

marco grosso pre operation representation

Intra OP

Midline access and short K-wires placement

Neo Pedicle markers to mark the intended screw trajectory. Decompression.

3 x PLIF expandable cages in L2/3, L4/5, K5/S1 (26x10mm, 3° Suzhou Kangli Orthopedics)

Bone graft – calcium phosphate cement (Neocement®)

Posterior fixation with Neo Pedicle Screw System™

Totally 10 pedicle screws were placed over the levels L2 – S1

L2 – 2 x Ø7.0x50 mm
L3 – 2 x Ø7.0x50 mm
L4 – 2 x Ø7.0x50 mm
L5 – 2 x Ø7.0x50 mm
S1– 2 x Ø7.0x45 mm

Visualizations of the shape of one of the rods, both the sagittal and the coronal planes, in the iPad screen as a result from using the Neo ADVISE™ 2 x titanium rods 130mm straight, cut to final 120mm length.