E-Case report
Traumatic Fractures L3, L4, L5 + Os Sacrum
Posterior fixation L2 – IliumMichael Nienhaus, MD
David Schramm, MD
Pre OP
Clinical Case – Traumatic Fractures L3, L4, L5 + Os Sacrum
Posterior fixation L2 – Ilium
Neo ADVISE™
Orthopaedic – Trauma Surgeons
Helios HSK Wiesbaden
Wiesbaden, Germany
Dr. Michael Nienhaus
Dr. David Schramm
Patient Information
Young male patient, 18 years old, suffered multiple fractures in the lumbar area L3, L4, L5, and Os Sacrum.
Bone quality is very good.
Planned Surgery:
- Posterior fixation L2 – Ilium
- Percutaneous MIS surgery
- Fracture stabilization
- Neo ADVISE™ fixation module to be used for optimal rod contouring
Pre OP MRI confirming fresh fractures in L3, L4 and L5.
CT of sacrum
Intra OP
Preparing for the surgery
Access and K-wires in ilium placed.
Monitoring the surgical steps with fluoroscopy guidance.
Posterior fixation with Neo Pedicle Screw System™
Totally 6 pedicle screws placed in levels L2, L3 and Ilium.
- L2 – 2 x Ø5.0x45 mm
- L3 – 2 x Ø6.0x45 mm
- Ilium – 2 x Iliac screws; Ø8.0x80 mm
Results from using the Neo ADVISE™ fixation module in both the left side and the right side. The minimum rod length and the screw head positions are shown.
Visualizations of the rods in both the sagittal and the coronal planes in the iPad screen.
Rod selection: 2 x Titanium rods 160mm straight.
The 160 mm rod was cut, shortened to 150 mm
Post OP
Post OP radiographs
- Intra OP Blood loss: 150 ml
- Duration of surgery: 110 min
- Patient was discharged from the hospital after 2 days
Published with the approval of Dr. Michael Nienhaus & Dr. David Schramm