E-Case report :

Multiple Trauma Case L1‑S1Thomas Schachtschabel

Pre OP

Clinical Case – Multiple Trauma  L1 – S1

Thomas Schachtschabel
Neurosurgeon
ORTHO CENTRUM SAALE
Bad Neustadt Saale/Gersfeld
Germany

Patient Information

A 62-year-old female patient suffered multiple, painful vertebral fractures in the lumbar spine: L1 (old), and fresh fractures in L2, L3, and L4.

Osteoporotic / osteopenic bone quality.

Surgery was planned for stabilization with a 5-levels posterior instrumentation, with the Neo Pedicle Screw System™.

Pre OP radiograph and CTs sagittal views

Pre OP radiograph and CTscans frontal views

Intra OP

Surgical Procedure

Patient was treated under general anesthesia. Mini open surgery from lateral side.
Placement of K-wires to define correct screw positions.

Fused segments L1-S1

Neo Pedicle Screw System™
10 x Ø6.0 x 45mm in L1-L5
2 x Ø7.0 x 45mm in S1
2 x 160 mm titanium rods

First pedicle screws placed

Continuing pedicle screw placement of totally 12 pedicle screws.

Considering the osteoporotic bone quality, 1 ml (cc) BonOs® (OSARTIS) bonecement was injected in each of levels L1, L2 and L4.

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.

Rod Selection, length of rod, fit of the right side rod

Guide tower relative height check for rod contouring

Checking the rod

Rod fixed before rod holder release

Final tightening

Total intraoperative blood loss: 200ml.
Duration of surgery: 120 minutes.
Neurological status OK.
Pain ISG on the right side.

Patient was discharged from hospital 8 days after surgery.

Post OP

Post OP radiographs, sagittal views

Post OP radiographs, frontal views

Published with the approval of
Thomas Schachtschabel