E-Case report
Degenerative Disc Disease L4‑S1Dr. med. Michael Kuhr Dr. med. Stefan Kirschbaum
![February-–-Dr.-Kuhr-&-Dr.-Kirschbaum](https://neo-medical.com/wp-content/uploads/2021/02/February-–-Dr.-Kuhr-Dr.-Kirschbaum-3.png)
Pre OP
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Clinical Case – Degenerative Disc Disease
Dr. med. Michael Kuhr
Dr. med. Stefan Kirschbaum
Praxis für Neurochirurgie / Orthopädische Praxis für Gelenkchirurgie, Unfallchirurgie und Sportmedizin
Rotenburg an der Fulda,
Germany
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![Med-Michael-Kuhr](https://neo-medical.com/wp-content/uploads/2021/02/Med-Michael-Kuhr-1.jpg)
![Photo-Dr.-Kirschbaum](https://neo-medical.com/wp-content/uploads/2021/02/Photo-Dr.-Kirschbaum.jpg)
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
28 year old female patient. Degenerative disc disease in the lower lumbar area.
Instability, abrasion and pain from the facet joints L4/L5 left side, and L5/S1 right side.
Slipped discs at both levels.
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![pre-op](https://neo-medical.com/wp-content/uploads/2021/02/pre-op.png)
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
Pre OP MRIs sagittal, frontal and axial views
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Intra OP
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Combined MIS and mini-open TLIF surgery.
Wiltse approach.
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![intra-op](https://neo-medical.com/wp-content/uploads/2021/02/intra-op.png)
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Approach Wiltse for TLIF Neo Curved Cages implantation:
Neo Curved Cages: 36/12 mm, Lordosis 5° in level L4/L5, and 36/9 mm, lordosis 5° in level L5/S1.
![Intra OP Wiltse Approach 2](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-Wiltse-Approach-2.jpg)
![Intra OP Wiltse approach 1](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-Wiltse-approach-1.jpg)
![Intra OP placing the Neo cage](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-placing-the-Neo-cage.jpg)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Intra OP Radiographs, sagittal and frontal views
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![Intra-OP-x-ray-cages-placed-sagittal](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-x-ray-cages-placed-sagittal.jpg)
![Intra-OP-x-ray-cages-placed-frontal-view](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-x-ray-cages-placed-frontal-view.jpg)
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
K-wire placement; with one incision covering all 3 vertebral levels
![montage-intra-op-new](https://neo-medical.com/wp-content/uploads/2021/02/montage-intra-op-new.png)
![Intra OP placing Neo pedicle system 1](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-placing-Neo-pedicle-system-1-scaled.jpg)
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Placing the Neo Pedicle Screw System
4 x Ø6.0 x 40mm
2 x Ø6.0 x 35mm
![Intra OP Placing Neo pedicle screw system 2](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-Placing-Neo-pedicle-screw-system-2-scaled.jpg)
![Intra OP placing Neo pedicle screw system 3](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-placing-Neo-pedicle-screw-system-3-scaled.jpg)
![Intra OP x-ray placing Neo Pedicle screw system](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-x-ray-placing-Neo-Pedicle-screw-system-scaled.jpg)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b-1.png)
![pre-op-3](https://neo-medical.com/wp-content/uploads/2021/01/pre-op-3.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Rod measuring and placement of Neo Pre-bent rods.
Pre-bent 60mm rod placed at the right side, and a pre-bent 70mm rod at the left side.
![Intra OP Rod measuring](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-Rod-measuring-scaled.jpg)
![Intra OP rod placement 1](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-rod-placement-1-scaled.jpg)
![Intra OP rod placement 2](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-rod-placement-2-scaled.jpg)
![Intra-OP-x-ray-rod-placement](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-x-ray-rod-placement.jpg)
Final tightening of the posterior instrumentation
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![Intra OP Final tightening](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-Final-tightening-scaled.jpg)
![Intra OP final tightening 2](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-final-tightening-2-scaled.jpg)
![Intra-OP-x-ray-final-tightening](https://neo-medical.com/wp-content/uploads/2021/02/Intra-OP-x-ray-final-tightening.jpg)
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Post OP
Post OP Radiographs, sagittal and frontal views
![Post-OP-radiograph-sagittal-view](https://neo-medical.com/wp-content/uploads/2021/02/Post-OP-radiograph-sagittal-view.jpg)
![Post-OP-radiograph-frontal-view](https://neo-medical.com/wp-content/uploads/2021/02/Post-OP-radiograph-frontal-view.jpg)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b-1.png)
![Radiograph 8 moths Follow Up Sagittal view](https://neo-medical.com/wp-content/uploads/2021/02/Radiograph-8-moths-Follow-Up-Sagittal-view.jpg)
![Radiograph 8 months Follow Up frontal view](https://neo-medical.com/wp-content/uploads/2021/02/Radiograph-8-months-Follow-Up-frontal-view-e1614681196337.jpg)
8 months Follow Up Radiographs, sagittal and frontal views
![ligne](https://neo-medical.com/wp-content/uploads/2021/01/ligne.png)
Published with the approval of
Dr. med. Michael Kuhr
Dr. med. Stefan Kirschbaum
![logo](https://neo-medical.com/wp-content/uploads/2021/02/logo.png)