A case study demonstrating the limitations of a single-disc replacement in correcting a spinal flat-back deformity: (a–c) a 45-year-old obese male patient.

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Presentation transcript:

A case study demonstrating the limitations of a single-disc replacement in correcting a spinal flat-back deformity: (a–c) a 45-year-old obese male patient underwent posterolateral fusion in 1998 and had significant mechanical back and leg pain thereafter; he presented with bilateral foot drop and severe low-back pain 5 years later; (d–g) after junctional disc replacement the patient was doing well during follow-up until 2 years after the index surgery; (h) at 26 months post-index surgery the patient re-presented with spinal stenosis, a rightsided foot drop, and severe low-back pain; radiographs showed extended disc prosthesis and myelography confirmed spinal stenosis behind disc prosthesis; (i, j) after double osteotomy (OT) (pedicle substraction OT L5 and multiple lower thoracic OTs as well as a direct posterior decompression L3–L4), rebalancing of the prosthetic disc and complete relief from symptoms. A case study demonstrating the limitations of a single-disc replacement in correcting a spinal flat-back deformity: (a–c) a 45-year-old obese male patient underwent posterolateral fusion in 1998 and had significant mechanical back and leg pain thereafter; he presented with bilateral foot drop and severe low-back pain 5 years later; (d–g) after junctional disc replacement the patient was doing well during follow-up until 2 years after the index surgery; (h) at 26 months post-index surgery the patient re-presented with spinal stenosis, a rightsided foot drop, and severe low-back pain; radiographs showed extended disc prosthesis and myelography confirmed spinal stenosis behind disc prosthesis; (i, j) after double osteotomy (OT) (pedicle substraction OT L5 and multiple lower thoracic OTs as well as a direct posterior decompression L3–L4), rebalancing of the prosthetic disc and complete relief from symptoms. Ulrich R. Hähnle et al. Int J Spine Surg 2007;1:85-92 Copyright SAS - Spine Arthroplasty Society 2007