E-Case report
Osteoporotic Fractures
Posterior long segment fixation T8 – L3Dr. med. Patrick Weidle
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Pre OP
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Clinical Case – Osteoporotic Fractures
Posterior long segment fixation T8 – L3
Dr. Patrick A. Weidle
Head of Musculoskeletal – Center MG
Head of Department for Orthopaedics-, Trauma-, Spine Surgery and Interventional Pain Therapy
Krankenhaus Neuwerk
Mönchengladbach
Germany
![entreprise](https://neo-medical.com/wp-content/uploads/2023/03/entreprise.png)
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![patrick-A-weidle](https://neo-medical.com/wp-content/uploads/2021/05/patrick-A-weidle.png)
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Patient Information
Female 80 years old patient suffers from osteoporotic fractures in the thoraco-lumbar junction area, T10, T11 and L2.
Diagnoses:
- T10 – OF1-FX
- T11 – OF5-FX – Kyphosis T10-T12 Cobb-Angle 57° with temp. Plegia
- L2 – OF1-FX
- Adult Scoliosis
- Osteoporosis – Bone density T-score: -3.5
The patient has been conservatively treated by the General Practitioner.
![patient-information](https://neo-medical.com/wp-content/uploads/2023/03/patient-information.jpg)
Schnake KJ, Blattert TR, Hahn P, et al. Spine Section of the German Society for Orthopaedics and Trauma. Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Global Spine J. 2018 Sep;8(2 Suppl):46S-49S.
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![pre-op-1-weidle marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/03/pre-op-1-weidle.png)
Pre OP CT and radiograph,
sagittal & coronal views
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Pre OP radiograph coronal & MRIs sagittal
![pre-op-2-weidle](https://neo-medical.com/wp-content/uploads/2023/03/pre-op-2-weidle.jpg)
![pre-op-2-weidle](https://neo-medical.com/wp-content/uploads/2023/03/pre-op-2-weidle.png)
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![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
OR-Strategy:
- Open spondylodesis T8-L3 in IONM and 3D-navigation
- Cement augmentation of all screws
- Modified PSO T11 & reduction with AR technology
- Quattro rod enhanced fixation with parallel 4 connectors
Secondary surgery:
- TT-VBR T11
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Intra OP
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
- Posterior long segment fixation with the Neo Pedicle Screw System™
- Totally 14 screws in T8 – L3 levels
- All pedicle screws were placed with guidance/support of navigation
- Surgery performed with help of IONM
- Quattro rod enhanced the fixation with 4 parallel connectors. The satellite rods were used to achieve increased stability.
![intra ope](https://neo-medical.com/wp-content/uploads/2023/03/intra-ope.png)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b.png)
![intra ope 2 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/03/intra-ope-2.png)
- All screws were cement augmented because of the poor bone quality.
- Correction supported by Schwab 2/3 modified PSO
- AR supported technology was used to objectify the amount of the intraoperative correction: From 67° to 13.4° at the thoracolumbar junction.
- Vertebral Body Replacement T11 will follow in 2nd surgery.
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Post OP
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Post OP radiographs,
sagittal & coronal views
![post ope](https://neo-medical.com/wp-content/uploads/2023/03/post-ope.png)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b.png)
Published with the approval of Dr. Patrick Weidle