Multilevel Spondylolysis Repair Using the 'Smiley Face' Technique with 3-Dimensional Intraoperative Spinal Navigation
| Autor: | Christopher D. Witiw, Adetunji Oremakinde, Mathew Voisin, Daipayan Guha, Shelly Wang, Ryan Deorajh, Victor X. D. Yang |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Visual analogue scale medicine.medical_treatment Spondylolysis Neurosurgical Procedures 03 medical and health sciences Imaging Three-Dimensional Spinal Stenosis 0302 clinical medicine Pedicle Screws medicine Back pain Humans In patient Neuronavigation 030222 orthopedics Intraoperative Care business.industry Leg pain Middle Aged medicine.disease Magnetic Resonance Imaging Spondylolisthesis Oswestry Disability Index Surgery Spinal fusion Neurology (clinical) medicine.symptom Tomography X-Ray Computed business Low Back Pain 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 109:e609-e614 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2017.10.046 |
| Popis: | Background/Objective Multilevel spondylolysis is a rare cause of progressive lower back pain, and patients who fail conservative management are treated surgically. Direct repair methods can maintain mobility and lead to decreased morbidity compared with spinal fusion in single-level spondylolysis. In this paper, we present a patient with nonadjacent multilevel spondylolysis who underwent the “smiley face” technique of direct multilevel repair without fusion using 3-dimensional intraoperative spinal navigation. Methods Bilateral spondylolysis at L3 and L5 with associated spondylolisthesis in a 50-year-old male was repaired using the “smiley face” technique. Patient-reported outcomes, including the Oswestry Disability Index (ODI) and visual analog scale scores for back and leg pain, were assessed preoperatively along with 6 weeks and 4 months postoperatively. Results Postoperative computed tomography imaging showed precise screw insertion and rod placement along with stable hardware alignment in follow-up imaging. The patient's ODI and lower back visual analog scale scores decreased from 25 to 8 and 7.5 to 4, respectively, correlating to an excellent outcome on ODI. Conclusion Direct repair and avoidance of fusion is possible and can provide good functional outcomes in patients with nonadjacent multilevel spondylolysis and associated spondylolisthesis. |
| Databáze: | OpenAIRE |
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