E-Case report
Tumor Metastasis L3
Posterior fixation L1 – L5 Alexander Franck, MD
Pre OP
Clinical Case – Tumor Metastasis L3
Posterior fixation L1 – L5
Neo ADVISE™ -Fixation module, 3D scanning
Dr. Alexander Franck
Orthopaedic/Trauma Surgeon
REGIOMED Klinikum Coburg
Coburg, Germany
Patient Information
59-year-old male patient with a tumor metastasis in L3 Palliative surgery
- Prostate cancer
- Hypertension
- Diabetes
- Moderate bone quality
- Neurological status incipient
Planned Surgery:
-
Palliative posterior fixation L1-L5
-
Percutaneous MIS surgery
-
In situ fixation
-
Neo ADVISE™ 3D scanning to be used
-
Midline approach > Decompression of L3
Pre OP CTs & MRIs
Frontal, sagittal & axial views
Intra OP
Planning surgery access and screw sizes
K-wires placement, starting at L1
Pedicle screws insertion, starting at L1
Posterior fixation with Neo Pedicle Screw System™
Totally 8 pedicle screws were placed over the levels L1-L5
- L1 – 2 x Ø8.0×55 mm polyaxial
- L2 – 2 x Ø8.0×55 mm polyaxial
- L4 – 2 x Ø8.0×50 mm polyaxial
- L5 – 2 x Ø8.0×50 mm polyaxial
Usage of Neo ADVISE™
Mapping of the guide towers
Results from using the Neo ADVISE™ Fixation module in both the right and theleft side
Visualizations of the rods in both the sagittal and the coronal planes in the iPad screen
The screw adjustments are color-coded into the virtual screw heads. The colors green, orange, and red indicate different levels of adjustments
Rod selection: 2 x Titanium rods 160mm straight, shortened to 145mm right rod, and 150mm left rod
Videos are showing all steps using Neo ADVISE™ fixation module in both the sides of the spine
Rod bending using the rod visualization in the iPad screen as template for both the sagittal and the coronal planes of both the rods
Rod placement & Final set screw tightening
Radiographs after final fixation and decompression of L3
Post OP
Post OP radiographs
- Duration of surgery: 150 min
- Neurological status: No problem
Published with the approval of Dr. Alexander Franck