E-Case report
Tumor Metastasis L3
Posterior fixation L1 – L5 Alexander Franck, MD
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Pre OP
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Clinical Case – Tumor Metastasis L3
Posterior fixation L1 – L5
Neo ADVISE™ -Fixation module, 3D scanning
Dr. Alexander Franck
Orthopaedic/Trauma Surgeon
REGIOMED Klinikum Coburg
Coburg, Germany
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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:
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Palliative posterior fixation L1-L5
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Percutaneous MIS surgery
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In situ fixation
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Neo ADVISE™ 3D scanning to be used
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Midline approach > Decompression of L3
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Pre OP CTs & MRIs
Frontal, sagittal & axial views
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Intra OP
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![intra-op-4](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-4-2.jpg)
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Planning surgery access and screw sizes
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K-wires placement, starting at L1
![intra-op-7](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-7-1.jpg)
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Pedicle screws insertion, starting at L1
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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
![intra-op-14](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-14.jpg)
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Usage of Neo ADVISE™
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Mapping of the guide towers
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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
![intra-op-17](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-17.png)
![intra-op-18](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-18.png)
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
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Videos are showing all steps using Neo ADVISE™ fixation module in both the sides of the spine
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![intra-op-19](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-19.jpg)
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Rod bending using the rod visualization in the iPad screen as template for both the sagittal and the coronal planes of both the rods
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Rod placement & Final set screw tightening
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Radiographs after final fixation and decompression of L3
![intra-op-24](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-24.jpg)
![intra-op-25](https://neo-medical.com/wp-content/uploads/2023/09/intra-op-25.jpg)
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Post OP
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Post OP radiographs
- Duration of surgery: 150 min
- Neurological status: No problem
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Published with the approval of Dr. Alexander Franck