E-Case report
Tumor Vertebral Fracture L1
Posterior fixation T10 – L3Miguel Alquiza, MD
![](data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAA2YAAAEJAQAAAADXkwn1AAAAAnRSTlMAAHaTzTgAAAAySURBVHja7cEBAQAAAIIg/69uSEABAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAPBtx3gABXqRhawAAAABJRU5ErkJggg==)
![intro](https://neo-medical.com/wp-content/uploads/2023/05/intro.jpg)
Pre OP
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Clinical Case – Tumor
Vertebral Fracture L1
Posterior fixation T10 – L3
Neo ADVISE™ Trauma module
Dr. Miguel Alquiza
Head of Spine Department
Evangelisches Waldkrankenhaus Spandau Berlin, Germany
![logo-Evangelisches Waldkrankenhaus Spandau](https://neo-medical.com/wp-content/uploads/2023/05/logo-Evangelisches-Waldkrankenhaus-Spandau.jpg)
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![Dr-miguel-Alquiza](https://neo-medical.com/wp-content/uploads/2023/05/Dr-miguel-Alquiza.jpg)
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Patient Information
Female 84 years old patient diagnosed with a tumor related vertebral fracture in L1
Poor bone quality due to the metastatic tumor.
Planned Surgery:
- General Anestesia
- Posterior fixation T10 – L3
- Minimally Invasive Surgery
- Percutaneous access
- Neo ADVISE™ application to be used
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b-1.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Pre OP CT sagittal
![Pre-op-1 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/05/Pre-op-1.png)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Intra OP
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Posterior fixation with Neo Pedicle Screw System™
Totally 10 pedicle screws placed over the 6 vertebral levels T10 – L3
- 4 x Ø6.0×45 mm
- 4 x Ø7.0×50 mm
- 2 x Ø7.0×45 mm
- 2 x 130 mm titanium rods
![intrra-op-1](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-1-e1683816063802.jpg)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b.png)
K-wires to guide the placement of the pedicle screws, totally 10 screws inserted.
![intrra-op-2 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-2.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Cement augmentation: Osartis bone cement was used in most of the pedicle screws, 1ml per screw
![intrra-op-3](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-3.jpg)
![intrra-op-4](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-4.jpg)
![intrra-op-5](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-5.jpg)
![ligne](https://neo-medical.com/wp-content/uploads/2021/01/ligne.png)
DBM (Deminirealized Bone Matrix) used in the fractured L1 level
![intrra-op-6 marco grosso pre operation representation](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-6.jpg)
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Usage of Neo ADVISE™
![intrra-op-7](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-7.jpg)
ADVISE™ Markers placed
Marker Scanning
![ligne](https://neo-medical.com/wp-content/uploads/2021/01/ligne.png)
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Usage of Neo ADVISE™ trauma module
![intrra-op-8](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-8.jpg)
Rod selection
Titanium rods 2 x 130 mm straight
![intrra-op-9](https://neo-medical.com/wp-content/uploads/2023/05/intrra-op-9.jpg)
Rod bending using the rod visualization in the iPad screen as template for thesagittal plane.
Final tightening and screw extender removal
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Post OP
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
Radiographs after final fixation of the posterior constructions
Duration of surgery: : 1h 45min
![post-op](https://neo-medical.com/wp-content/uploads/2023/05/post-op.png)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b.png)
Published with the approval of
Dr. Miguel Alquiza