Download CLINICAL CASE

Master Meeting: Spinal Deformities
Minneapolis – MN
Renato J. Muniz Teixeira MD
Rio de Janeiro-Brazil
T1
Full XR:
Adult Degenerative
Scoliosis Type V.
Apex L2
No Sagittal Imbalance
T12
40º
40º
SS=45º
L5
PT=40º
PI=85º
PI= 85º ( 40-65º)
PT= 40º ( 10-25º)
SS= 45º ( 30-45º)
LL = 40º
DIAGNOSIS
MR: Multilevel Stenosis. L4-L5 Retrolistesis. L3-L4 Foraminal Stenosis.
L2-L3 Disc Herniation
SURGICAL TREATMENT
What To Make ?
 Nothing
Scoliosis Surgery:
 Instrumented Fusion from T10 to L5
 Only DDD Surgery  Instrumented Fusion from T10 to S1
 Scoliosis Surgery
 Instrumented Fusion from T10 and
Sacroiliac Fixation
 Anterior Fusion in the Levels:
- L5-S1
- L4-S1
- L4-L5
- L3-L5
 All options
 Others Options
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?
 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 ?
Retropulsion
L4-L5 Cages
Pull Out S1 Screws


Recolocate the
Implants

L5-S1 double Fusion

Sacropelvic Fixation

Osteotomies
- SP-O
- PSO
All the Options
Alphatec Spine Aca
New Surgery 2010/7/5
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!