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“360-degree” (“front-back”) Surgical Reconstruction of “Isthmic” and Advanced “Degenerative” Spondylolisthesis: ALIF with Posterior Back-up Instrumentation

BACKGROUND If there is a congenital (developmental) defect of a posterior stabilising structure of the spine called the pars interarticularis, then a spinal slip (spondylolisthesis) can arise from this “pars defect“. It usually becomes apparent in a person’s 30s to 40s, as the symptoms of low back pain +/- leg symptoms become more apparent and […]

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Visual example comparing the resolution of 3T MRI vs. (standard) 1.5T MRI in spinal imaging

The same patient underwent a standard 1.5T (T=Tesla) MRI of the lumbar spine in early 2022 (left panel, above), and then a 3T MRI of the lumbar spine in late 2022 (right panel, above). You can see the left image (1.5T magnetic field strength) is of much lower resolution than the right image (3T magnetic […]

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Radiological and clinical follow-up, at 7 years after prosthetic insertion (ROI-A and Chesapeake-type fusion cages)

I recently saw, as part of voluntary long-term follow-up that I requested, some of my patients in whom I inserted fusion cages in their lower lumbar spines (anterior lumbar interbody fusion; ALIF) for, e.g., military trauma and subsequent degeneration (gentleman now in his late 70s; Image 1; ROI-A dual integrated ‘gull-wing’ cages) and road accident […]

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Radiological follow-up of some of my anterior lumbar prosthetic patients: ROI-A fusion cages and LP-ESP artificial discs at 1 to 6 years post-insertion

The anterior lumbar “hybrid” surgery patient’s images below involved replacement of her worn, damaged and symptomatic L3/4 and L4/5 discs (left panel, Pre-op) with an LP-ESP artificial disc at L3/4 and a ROI-A fusion cage at L4/5. The centre panel shows the prosthetics at 1 year post-op and the right panel shows them at 4+ […]

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