E-Case report
Osteoporotic Fracture – L1 – L3Dr. med. Ali Noufal
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Pre OP
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Clinical Case – Osteoporotic Fracture – L1 – L3
Dr. med. Ali Noufal
Orthopaedic/Trauma Surgeon
REGIOMED Klinikum Sonneberg
Germany
![regiomed-kliniken](https://neo-medical.com/wp-content/uploads/2022/05/regiomed-kliniken.jpg)
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![Dr-Ali-Noufal](https://neo-medical.com/wp-content/uploads/2022/05/Dr-Ali-Noufal.jpg)
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Patient Information
An 82-year-old female patient suffered an osteoporotic vertebral compression fracture in the lumbar spine, L2.
Compromised, osteoporotic bone quality.
The surgery was planned for fracture reduction and stabilization with a 2-levels, L1-L3, posterior instrumentation using the Neo Pedicle Screw System™.
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b-1.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
![pre-op-1](https://neo-medical.com/wp-content/uploads/2022/05/pre-op-1.jpg)
Pre OP CT sagittal
and radiograph frontal views
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Intra OP
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Patient was treated under general anesthesia. Percutaneous, lateral access.
Placement of K-wires to define correct screw positions.
![intra-op-1](https://neo-medical.com/wp-content/uploads/2022/05/intra-op-1.jpg)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b.png)
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![intra-op-2](https://neo-medical.com/wp-content/uploads/2022/05/intra-op-2.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)
Fused segments L1-L3, with intermediate screws in the fractured L2 vertebra.
Neo Pedicle Screw System™
- L1: 2 x Ø6.0 x 50 mm monoaxial
- L2: 2 x Ø6.0 x 35mm monoaxial
- L3: 2 x Ø6.0 x 50mm
![intra-op-3](https://neo-medical.com/wp-content/uploads/2022/05/intra-op-3-1.jpg)
![ligne-2b-1-reverse](https://neo-medical.com/wp-content/uploads/2022/01/ligne-2b-1-reverse.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
![intra-op-4](https://neo-medical.com/wp-content/uploads/2022/05/intra-op-4.jpg)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Considering the osteoporotic bone quality, 1 ml (cc) BonOs® (OSARTIS) bonecement was injected in each of levels L1 and L3.
![intra-op-5](https://neo-medical.com/wp-content/uploads/2022/05/intra-op-5.jpg)
![intra-op-6](https://neo-medical.com/wp-content/uploads/2022/05/intra-op-6.jpg)
All Neo pedicle screws are cannulated and fenestrated, giving the surgeon the possibility to decide during the surgery to use bone cement for increased boneanchorage in compromised bone quality.
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Rod Selection: 2 x 70 mm straight titanium rods.
Rod placement and fracture reduction.
![intra-op-7](https://neo-medical.com/wp-content/uploads/2022/05/intra-op-7.jpg)
![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)
Final tightening of the set screws
![intra-op-8](https://neo-medical.com/wp-content/uploads/2022/05/intra-op-8.jpg)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Total intraoperative blood loss: 250ml.
Duration of surgery: 90 minutes.
Neurological status OK.
Patient was discharged from hospital 7 days after surgery.
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Post OP
Post OP radiographs, sagittal and frontal views
A small cement leakage could be seen in the L1 level.
![post-op-1](https://neo-medical.com/wp-content/uploads/2022/05/post-op-1.jpg)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b-1.png)
Published with the approval of Dr. med. Ali Noufal