E-Case report :

Osteoporotic Fracture – L1 – L3Dr. med. Ali Noufal

Pre OP

Clinical Case – Osteoporotic Fracture – L1 – L3

Dr. med. Ali Noufal
Orthopaedic/Trauma Surgeon
REGIOMED Klinikum Sonneberg
Germany

Patient Information

An 82-year-old female patient suffered an osteoporotic vertebral compression  fracture in the lumbar spine, L2.

Compromised, osteoporotic bone quality.

The surgery was planned for fracture reduction and stabilization with a 2-levels, L1-L3, posterior instrumentation using the Neo Pedicle Screw System™.

Pre OP CT sagittal
and radiograph frontal views

Intra OP

Patient was treated under general anesthesia. Percutaneous, lateral access.

Placement of K-wires to define correct screw positions.

Fused segments L1-L3, with intermediate screws in the fractured L2 vertebra.

Neo Pedicle Screw System™

  •   L1:  2 x Ø6.0 x 50 mm monoaxial
  •   L2:  2 x Ø6.0 x 35mm monoaxial
  •   L3:  2 x Ø6.0 x 50mm

Considering the osteoporotic bone quality, 1 ml (cc) BonOs® (OSARTIS) bonecement was injected in each of levels L1 and L3.

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: 2 x 70 mm straight titanium rods.

Rod placement and fracture reduction.

Final tightening of the set screws

Total intraoperative blood loss: 100ml.

Duration of surgery: 90 minutes.

Neurological status OK.

Patient was discharged from hospital 7 days after surgery.

Post OP

Post OP radiographs, sagittal and frontal views

A small cement leakage could be seen in the L1 level.

Published with the approval of Dr. med. Ali Noufal