Master Meeting: Spinal Deformities

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Presentation transcript:

Master Meeting: Spinal Deformities Minneapolis – MN Renato J. Muniz Teixeira MD Rio de Janeiro-Brazil

Full XR: Adult Degenerative Scoliosis Type V. Apex L2 No Sagittal Imbalance T12 40º 40º SS=45º PI= 85º ( 40-65º) PT= 40º ( 10-25º) SS= 45º ( 30-45º) LL = 40º L5 PT=40º PI=85º

DIAGNOSIS MR: Multilevel Stenosis. L4-L5 Retrolistesis. L3-L4 Foraminal Stenosis. L2-L3 Disc Herniation

SURGICAL TREATMENT What To Make ? Scoliosis Surgery: Instrumented Fusion from T10 to L5 Instrumented Fusion from T10 to S1 Instrumented Fusion from T10 and Sacroiliac Fixation Anterior Fusion in the Levels: - L5-S1 - L4-S1 - L4-L5 - L3-L5 All options Others Options Nothing Only DDD Surgery Scoliosis Surgery

PRE-OP IMAGING Female 47 years old Important lumbar pain. VAS 9/10 Without neurologic clinic VAS 0/10 Scoliosis Deformity in the Clinical exploration No reaction at all type of the Treatment including Pain Unit

SURGICAL TREATMENT Surgery 2010/2/22 PLT T10-L5 TLIF L3-L5 The patient gets out of Hospital in ten days

SURGICAL TREATMENT 45 days of the Follow-Up Negative Sagittal Balance Positive Sagittal Balance

POST-OP EVALUATION What is the Ethiologic? Pull Out S1 Screws No Sacropelvic Fixation No S1 Screw and L5-S1 TLIF Stress Fracture of the L5 No Good Lumbar Lordosis All the Options What To Make Now ? Recolocate the Implants L5-S1 double Fusion Sacropelvic Fixation Osteotomies - SP-O - PSO All the Options Retropulsion L4-L5 Cages Pull Out S1 Screws

Alphatec Spine Aca New Surgery 2010/7/5 Betterr Sagital Balance Relocation L4-L5 cages We put S1 screws We made L5-S1 bone fusion Sacropelvic Fixation Seven years of the Follow up. The patien is perfect No more complications Betterr Sagital Balance

Большое спасибо!