E-Case report
DDD, Degenerative Disc Disease
Spinal Fusion L2 – S1Konstantinos Kafchitsas, MD PD
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Pre OP
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Clinical Case – Degenerative Disc Disease
Spinal Fusion L2 – S1
Neo ADVISE™
PD Dr. Konstantinos Kafchitsas
Asklepios Klinik Lindenlohe
Schwandorf
Germany
![image6](https://neo-medical.com/wp-content/uploads/2023/09/image6.jpg)
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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
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Pre OP standing radiographs & MRI, frontal and sagittal views.
![image8 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/image8.jpg)
![image7 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/image7.jpg)
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Intra OP
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Midline access and short K-wires placement
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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®)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Posterior fixation with Neo Pedicle Screw System™
Totally 10 pedicle screws were placed over the levels L2 – S1
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L2 – 2 x Ø7.0x50 mm
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L3 – 2 x Ø7.0x50 mm
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L4 – 2 x Ø7.0x50 mm
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L5 – 2 x Ø7.0x50 mm
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S1– 2 x Ø7.0x45 mm
![ligne-2b-1-reverse](https://neo-medical.com/wp-content/uploads/2022/01/ligne-2b-1-reverse.png)
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
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.
![image15](https://neo-medical.com/wp-content/uploads/2023/09/image15.jpg)
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Radiographs after the final fixation of the posterior construction, and removal of the instrumentation
- Duration of surgery: 3h45min
- Post OP VAS: 4
- Patient was discharged from hospital after 13 days
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Post OP
Radiographs after the final fixation of the posterior construction, and removal of the instrumentation
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Post OP radiographs
Radiographs, sagittal and frontal views at 3 months Post OP
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Published with the approval of Dr. Konstantinos Kafchitsas