E-Case report
High-energy Trauma Fractures T8 & T11
Posterior fixation T4 – L1Eckard Hölscher, MD
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![retouche-neo](https://neo-medical.com/wp-content/uploads/2024/02/retouche-neo.jpg)
Pre OP
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Clinical Case – High-energy Trauma Fractures T8 & T11
Posterior fixation T4 – L1
Neo ADVISE™
Eckard Hölscher, MD
Orthopaedic/Trauma Surgeon
Helios Klinikum Berlin Buch
Berlin
Germany
![logos](https://neo-medical.com/wp-content/uploads/2023/06/logos.jpg)
![Photo Dr. Eckard Hölscher-1](https://neo-medical.com/wp-content/uploads/2024/02/Photo-Dr.-Eckard-Holscher-1.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Patient information
Male 56 years old patient, construction worker who was admitted to the emergency department after a fall at work.
Polytrauma, multiple fractures: Vertebral fractures in
T8 – Endplate impression fracture
T11 – Burst fracture, type B
Fibula fracture
Calcaneus fracture
Neurological status: OK
Good bone quality
Planned Surgery:
- Posterior fixation, long construction (10 levels) T4 – L1
- Percutaneous MIS surgery
- Neo ADVISE™ , marker option, to be used
![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)
Pre OP MRIs
Sagittal & frontal views
![pre-op-1](https://neo-medical.com/wp-content/uploads/2023/06/pre-op-1.jpg)
![pre-op-2](https://neo-medical.com/wp-content/uploads/2023/06/pre-op-2.jpg)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Intra OP
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
![intra-op-1](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-1.jpg)
Pedicle screws are placed guided by the K-wires
![intra-op-2](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-2.jpg)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Posterior fixation, long construct, with the Neo Pedicle Screw System™
Totally 16 pedicle screws placed over the levels T4 – L1 (no screws in the fractured levels T8 and T11)
- T4 – 2 x Ø4.5×45 mm
- T5 – 2 x Ø4.5×45 mm
- T6 – 2 x Ø5.0×45 mm
- T7 – 2 x Ø5.0×40 mm
- T9 – 2 x Ø6.0×50 mm
- T10 – 2 x Ø6.0×55 mm
- T12 – 2 x Ø7.0×55 mm
- L1 – 2 x Ø5.0×50 mm
![intra-op-3](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-3-1.jpg)
![intra-op-4](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-4.jpg)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Neo ADVISE™
Marker Detection Method Markers are attached onto the screw guides.
The Marker Detection method works for scanning the guides on both sides of the spine at the same time.
![intra-op-5](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-5-e1686298750467.png)
![intra-op-G](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-G.jpg)
![intra-op-D](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-D.jpg)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Mapping the markers, using the iPad screen
![intra-op-6](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-6-1.jpg)
![intra-op-7](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-7.jpg)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Bending of the left side rod, 300mm straight, by using the visualization of the rod in the sagittal plane shown in the iPad screen.
![intra-op-8](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-8.jpg)
![intra-op-9](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-9-1.jpg)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
![intra-op-10](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-10-1.jpg)
Placing left side rod
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
![intra-op-11](https://neo-medical.com/wp-content/uploads/2023/06/intra-op-11-1.jpg)
Pre-fixation of the set screws, using the torque limiter attached to the handle.
![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)
Radiographs, sagittal view, after final fixation of the posterior construction and removal of the instrumentation.
![post-op-1](https://neo-medical.com/wp-content/uploads/2023/06/post-op-1.jpg)
![post-op-2](https://neo-medical.com/wp-content/uploads/2023/06/post-op-2.jpg)
![post-op-3](https://neo-medical.com/wp-content/uploads/2023/06/post-op-3.jpg)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Post OP
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Post OP radiographs, frontal
- Intra OP Blood loss: 700 ml
- Duration of surgery: 180 min
- Patient was discharged from the hospital after 13 days
![post-op-5](https://neo-medical.com/wp-content/uploads/2023/06/post-op-5.jpg)
![post-op-4](https://neo-medical.com/wp-content/uploads/2023/06/post-op-4.jpg)
![post-op-6](https://neo-medical.com/wp-content/uploads/2023/06/post-op-6.jpg)
![ligne](https://neo-medical.com/wp-content/uploads/2021/01/ligne.png)
Published with the approval of
Eckard Hölscher, MD