E-Case report
Multiple Trauma Case L1‑S1Thomas Schachtschabel
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Pre OP
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Clinical Case – Multiple Trauma L1 – S1
Thomas Schachtschabel
Neurosurgeon
ORTHO CENTRUM SAALE
Bad Neustadt Saale/Gersfeld
Germany
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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™.
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Pre OP radiograph and CTs sagittal views
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Pre OP radiograph and CTscans frontal views
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Intra OP
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Surgical Procedure
Patient was treated under general anesthesia. Mini open surgery from lateral side.
Placement of K-wires to define correct screw positions.
![intra-op-1](https://neo-medical.com/wp-content/uploads/2022/02/intra-op-1.png)
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![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
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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
![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)
Continuing pedicle screw placement of totally 12 pedicle screws.
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Considering the osteoporotic bone quality, 1 ml (cc) BonOs® (OSARTIS) bonecement was injected in each of levels L1, L2 and L4.
![intra-op-6](https://neo-medical.com/wp-content/uploads/2022/02/intra-op-6.png)
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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.
![intra-op-7](https://neo-medical.com/wp-content/uploads/2022/02/intra-op-7.png)
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![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Rod Selection, length of rod, fit of the right side rod
![intra-op-9](https://neo-medical.com/wp-content/uploads/2022/02/intra-op-9.png)
Guide tower relative height check for rod contouring
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Checking the rod
![intra-op-11](https://neo-medical.com/wp-content/uploads/2022/02/intra-op-11-1.jpg)
Rod fixed before rod holder release
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Final tightening
![intra-op-10](https://neo-medical.com/wp-content/uploads/2022/02/intra-op-10.png)
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.
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Post OP
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Post OP radiographs, sagittal views
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Post OP radiographs, frontal views
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![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b-1.png)
Published with the approval of
Thomas Schachtschabel