E-Case report
Multi Segment Degenerative Deformity T11-L5Dr. med. Patrick Weidle
Pre OP
Clinical Case – Spondylolisthesis
Dr. med. Patrick A. Weidle
Head of Musculoskeletal-Center MG
Head of Department for Orthopaedic-, Trauma-, Spine-Surgery and interventional Pain Therapy
Krankenhaus Neuwerk
Mönchengladbach
Germany
Pre OP:
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78 years old female patient
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BMI 32.3 => Obesity
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Bone quality DXA T-Score -2.8=> Osteoporosis
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Old fracture in L4 (23 months old)
Medical condition:
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Severe Pain: VAS lumbar – 8/10 70%; VAS leg bilat – (r>l) 8/10 30%
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Medication: WHO°III – Metamizol 3000mg; Oxycodon 30 mg; Amitriptylin 20 mg (coanalgesic drug)
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Walking distance < 100 m with walking frame (claudicatio spinalis with severe pain ventral tigh bilat)
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Painfree walking distance: 0 m
Radiographs & CT in sagittal and frontal views
MRI, sagittal view
Intra OP
Surgical strategy:
- Open surgery
- General anaesthetic
- Complex repositioning spondylodesis T11 – L5 + Cement augmentation of pedicle screws in levels T11/T12/L1
- Laminectomy L2-4
- One-stage ventral fusion via TLIF L4/5 left + autograft
- Bilateral posterior fusion with auto- and Mastergraft (HA)
- Secondary fusion of the ventral spine L1-4 lateral via XLIF (bicortical) if necessary
Use of the Neo Pedicle Screw System™
T11: Ø5.0 x 45mm
T12: Ø5.0 x 45mm
L1: Ø5.0 x 50mm
L2: Ø6.0 x 50mm
L3: Ø6.0 x 50mm
L4: Ø6.0 x 50mm
L5: Ø6.0 x 50mm
Universal, all-features-in-one screw design
Video showing Dr. Weidle inserting the pedicle screw, removing the K-wire and checking to confirm maintained polyaxiality
Cement augmentation of pedicle screws in levels T11/T12/L1. All Neo pedicle screws are cannulated and fenestrated for optimal flexibility.
Total time of surgery:
218 minutes
Blood loss:
960ml (300ml re-transfused)
Post OP
Published with the approval of Dr. med. Patrick Weidle
The cement augmentation option not available in the United States.