E-Case report

Tumor Metastasis L3
Posterior fixation L1 – L5
Alexander Franck, MD

Pre OP

Clinical Case – Tumor Metastasis L3
Posterior fixation L1 – L5
Neo ADVISE™ -Fixation module, 3D scanning

Dr. Alexander Franck
Orthopaedic/Trauma Surgeon
Coburg, Germany

Patient Information

59-year-old male patient with a tumor metastasis in L3 Palliative surgery

  • Prostate cancer
  • Hypertension
  • Diabetes
  • Moderate bone quality
  • Neurological status incipient

Planned Surgery:

  1. Palliative posterior fixation L1-L5
  2. Percutaneous MIS surgery
  3. In situ fixation
  4. Neo ADVISE™ 3D scanning to be used
  5. Midline approach > Decompression of L3

Pre OP CTs & MRIs
Frontal, sagittal & axial views

Intra OP

Planning surgery access and screw sizes

K-wires placement, starting at L1

Pedicle screws insertion, starting at L1

Posterior fixation with Neo Pedicle Screw System™

Totally 8 pedicle screws were placed over the levels L1-L5

  • L1 –   2 x Ø8.0×55 mm polyaxial
  • L2 –   2 x Ø8.0×55 mm polyaxial
  • L4 –   2 x Ø8.0×50 mm polyaxial
  • L5 –   2 x Ø8.0×50 mm polyaxial

Usage of Neo ADVISE™

Mapping of the guide towers

Results from using the Neo ADVISE™ Fixation module in both the right and theleft side

Visualizations of the rods in both the sagittal and the coronal planes in the iPad screen

The screw adjustments are color-coded into the virtual screw heads. The colors green, orange, and red indicate different levels of adjustments

Rod selection: 2 x Titanium rods 160mm straight, shortened to 145mm right rod, and 150mm left rod

Videos are showing all steps using Neo ADVISE™ fixation module in both the sides of the spine

Rod bending using the rod visualization in the iPad screen as template for both the sagittal and the coronal planes of both the rods

Rod placement & Final set screw tightening

Radiographs after final fixation and decompression of L3

Post OP

Post OP radiographs

  • Duration of surgery: 150 min
  • Neurological status: No problem

Published with the approval of Dr. Alexander Franck