CNS Neurosurgery    |    Nice range of motion following ‘hybrid’ (artificial disc + cage) anterior lumbar spinal reconstruction

Nice range of motion following ‘hybrid’ (artificial disc + cage) anterior lumbar spinal reconstruction

This athletic man who also actively runs a large business enterprise had problems maintaining his quality of life from chronic progressive lumbar pain and sciatic symptoms. His two lowermost discs were quite degenerative as seen in the MRI image below (region of red dashed oval).

The two lower discs are probably the main culprits. Their height and hydration are lost (desiccation) and the lowermost disc (L5/S1) had degenerative bony endplate (Modic) changes indicative of loss of cushioning function of that disc.

We talked about his options and expectations. I put in an artificial disc at L4/5 and a cage at L5/S1, as part of a ‘hybrid’ (combination prosthetics) construct.

The post-operative CT shows his hybrid reconstruction. Nice restoration of disc heights, nice lordosis. No disc ‘sagginess’.

At around 6 months follow-up (below), he showed me his excellent range of motion, and he was much improved. Now asking to return to skiing/snow-boarding activities! I advised him to wait the full year before doing so.

The collage above shows some of his range of motion and activities, and the top right hand panel shows models of the prosthetics I implanted in him. These would the be same that would go into me if I needed this operation!
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