CNS Neurosurgery    |    Minimally invasive anterior approach used to replace failed posterior approach

Minimally invasive anterior approach used to replace failed posterior approach

This patient was recently referred for ongoing symptoms of low back and leg pain following a procedure done by someone interstate.  The construct (posteriorly placed instrumentation comprised of screws, hooks and rods) had failed to stabilise the spine or resolve the symptoms.

This is an x-ray of that posterior construct:

I first removed the construct using the other surgeon’s posterior incisions:

During the same operation, I then REPLACED ALL OF THE ABOVE with the following simple and elegant construct (ROI-A cage, integrated BoneCrunch fusion matrix in core; courtesy Device Technologies/LDR & AusBio/PointBlank Medical) via a minimally invasive small horizontal incision under the bikini line (anterior access provided by our technically gifted vascular surgeon); cage and post-op CT image is shown below:

I advise such patients to wear a custom-made lumbar brace fitted by one of our expert orthotists, for 3-4 months after such surgeries, whenever they’re walking around; they typically start walking the day after surgery. The lumbar brace looks like this:

We’ve had great results with the anterior approaches. Minimally invasive, elegant, and effective thus far!

 

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