E-Case report

Spondylolisthesis
T12-iliac in situ fixationAlexandre Delmotte, MD

Pre OP

Clinical Case – Spondylolisthesis

T12-iliac in situ fixation

Neo ADVISE™

Dr. Alexandre Delmotte
Neurosurgeon
Spine department
Clinique de la Sauvegarde
Lyon, France

Planned Surgery:

  1. General Anestesia
  2. Posterior fixation T12 – Iliac
  3. Open surgery, midline
  4. Neo ADVISE™ application to be used

Pre OP CT sagittal

marco grosso pre operation representation

Intra OP

Posterior fixation with Neo Pedicle Screw System™

Totally 16 pedicle screws to be placed over the 8 vertebral levels T12 – Iliac

OR table prepared & Incision midline

Pedicle preparation and pedicle markers are placed

K-wire placement and removal of the pedicle markers

Pedicle screw placement
Full tightening – ½ turn reverse

Polyaxiality check

All pedicle screws placed in all levels, including the iliac screws (T12-iliac)

Preparing to use the Neo ADVISE™

Change the lighting conditions to increase the contrast and avoid reflections (turn of the OP field lights)

Cleaning the guide towers. Note the use of a fabric to cover the left side whenADVISE™ is used at the right side

Scanning the right side and bending the rod using the visualization provided at the iPad screen
Note that the iliac screw guide is scanned from the same side

Rod insertion
OP field light is turned on again

Checking the seating of the rod into the pedicle screw heads

Set screw placement using the torque limiter

Rod prefixation and hold transfer

Radiographs showing that two of the set screws are not fully seated into the screw head

Final tightening of the fully seated set screws only, and guide towerremoval (1-2)

Further tightening of the previously not fully seated set screws (3) and check before final tightening (4)

ADVISE™ is used in the left side, to provide the rod shape visualizartion in the iPad screen which will be used as template to bend the rod.

Same surgical steps, rod placement and final fixation, are applied in the left side

Final screw tightening and check before closing

Post OP

Radiographs after final fixation of the posterior construction

T12-Iliac without connector

Published with the approval of
Dr. Alexandre Delmotte