Degenerative Disc Disease L5‑S1Dr. med. Santiago Solsona Espin
Clinical Case – Degenerative Disc Disease
Dr. med. Santiago Solsona Espin
Orthopaedic Surgeon & Trauma Surgeon
Specialty: Spine Surgery
52-year-old female patient, suffering from lumbar pain since >5 years.
The conservative treatment in rehabilitation and pain clinic has not been successfull.
In the last 8 months problems associated with radiculopathy S1 right side.
Functional disorders and Pain that affect her daily life activities:
Pain: VAS 8
Function: ODI 28 (56%)
- EMG: Radiculopathy S1 right side.
Pre OP radiographs sagittal & frontal views
MRIs (sagittal & axial) confirm severe L5-S1 degenerative discopathy with disc collapse, osteochondrosis and small right side subarticular hernia, hypertrophy and facet synovitis together with asymmetric listhesis.
It was decided to perform central and foraminal decompression + L5-S1 circumferential PL arthrodesis.
- Instrumentation using the universal Neo Pedicle Screw System™.
- Instrumentless compression maneuver through the use of the “Torque Limiters” with symmetrical reduction and sequential instrumentation assembly to fully control the applied forces.
Intra OP image confirming the anterior Neo Cage positioning
- Open surgical approach
- General anesthesia
- 1 level L5 – S1
- Neo Pedicle Screws:
- L5 Ø6.0 x 40mm
- S1 Ø7.0 x 35mm
- Neo Cage anatomical/curved 32mm, 7mm, 5°
- Rod 40mm pre-bent
Pedicle screws inserted & Polyaxiality check – Screw height
Rod selection & placement
The “Torque Limiter” allows us to pre-fix the rod/screw connection while preserving the screw polyaxiality
Final tightening of the rod to the screw heads at the cranial levels
Simultaneous and controlled reduction of the rod and definitive closure in the caudal level
Post OP radiographs, sagittal & frontal views
Post OP CT, axial view
Published with the approval of Dr. med. Santiago Solsona