E-Case report
Multiple Trauma T9, T10, T12
Posterior fixation T8 – L1Daniel Mahr, MD
Daniel Popp, MD, PD
![](data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAA2YAAAEJAQAAAADXkwn1AAAAAnRSTlMAAHaTzTgAAAAySURBVHja7cEBAQAAAIIg/69uSEABAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAPBtx3gABXqRhawAAAABJRU5ErkJggg==)
![featured image](https://neo-medical.com/wp-content/uploads/2023/09/featured-image.jpg)
Pre OP
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Clinical Case – Multiple Trauma Fractures T9, T10 and T12
Posterior fixation T8 – L1
Neo ADVISE™ -Fixation module, 3D scanning
Dr. Daniel Mahr
PD Dr. Daniel Popp
Orthopaedic/Trauma Surgeons
Universitätsklinikum Regensburg
Regensburg, Germany
![logo-qlinique](https://neo-medical.com/wp-content/uploads/2023/09/logo-qlinique.jpg)
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![doc-1](https://neo-medical.com/wp-content/uploads/2023/09/doc-1.jpg)
Dr. Daniel Mahr
![doc-2](https://neo-medical.com/wp-content/uploads/2023/09/doc-2.jpg)
PD Dr. Daniel Popp
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Patient Information
36-year-old male patient suffered severe cranial brain trauma and multiple vertebral fractures when he fell from a great height at his workplace
- Low impact fractures T9, T10 and T12
- Partly unstable fractures
- Skull surgery was performed a few days prior to the planned spine surgery
- Good bone quality
- Neurological status unknown
Planned Surgery:
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General anesthesia – ITN & TIVA
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Patient in prone position
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Mini-open surgery, percutaneous lateral approach
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Posterior fixation T8 – L1
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In situ fixation
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Neo ADVISE™ 3D scanning
![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 images, sagittal & axial views at the levels of the planned implant placements
![pre-op-1 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/pre-op-1.jpg)
![pre-op-2 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/pre-op-2.jpg)
![pre-op-3 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/pre-op-3.jpg)
![pre-op-4 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/pre-op-4.jpg)
![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)
![intra-op-1](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-1.jpg)
Access and K-wires placement
![intra-op-2](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-2.jpg)
![ligne-2b-1-reverse](https://neo-medical.com/wp-content/uploads/2022/01/ligne-2b-1-reverse.png)
![intra-op-3 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-3.jpg)
![intra-op-4 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-4-1.jpg)
Pedicle screws insertion
![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)
Posterior fixation with Neo Pedicle Screw System™
Totally 8 pedicle screws were placed over the levels T8 – L1
- T8 – 2 x Ø5.0x45 mm polyaxial
- T9 – 2 x Ø6.0x50 mm polyaxial
- T11 – 2 x Ø6.0x50 mm polyaxial
- L1 – 2 x Ø7.0x45 mm polyaxial
![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)
Video is showing all steps using Neo ADVISE™ fixation module in the left side of the spine
![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)
Visualizations of the left side rod in both the sagittal and the coronal planes in the iPad screen as a result from Neo ADVISE™ , and for the coronal plane with or without rod smoothing
![intra-op-5](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-5-e1694448883203.jpg)
Sagittal plane
![intra-op-6b](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-6b.jpg)
Coronal plane,
Rod smoothing OFF
![intra-op-7](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-7.jpg)
Coronal plane,
Rod smoothing ON
Rod Smoothing
On the Coronal plane, the poly-axiality of the screws is taken into account
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Rod placement
2 x Titanium rods 200mm straight, shortened to 180mm right rod, and 190mm left rod
![intra-op-8 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-8.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)
Radiographs after the final fixation of the posterior construction, removal of the instrumentation, and incisions sutured
![intra-op-9](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-9.jpg)
![intra-op-10](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-10.jpg)
![intra-op-11](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-11.jpg)
Post OP
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Post OP radiographs at discharge from the hospital
- Blood loss: 250 ml
- Duration of surgery: 180 min
![post-op-1](https://neo-medical.com/wp-content/uploads/2023/09/post-op-1.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Published with the approval of Dr. Daniel Mahr & Dr. Daniel Popp