Ibarra GJA, Ortiz GGV, Jiménez ÁJM

Language: Spanish
References: 10
Page: 239-244
PDF size: 389.18 Kb.

ABSTRACT

Introduction: Degenerative scoliosis and its management using the minimally invasive XLIF technique with indirect decompression and Neuromonitoring with Pedicle screw placement combined with TLIF in segments not accessible by XLIF, allows us to perform multisegmental corrections with complete correction of curves, as well as the reduction of radiation with the use of navigation and greater precision in the placement of pedicle screws with O-MRA the accuracy with 91 to 99% compared to 87-94% with C-MRA obtaining displacement of up to ≥ 4 mm lateral or medial with C-ARM and 20.7% complications without the use of navigation. Clinical case: A 62-year-old female patient comes to the office with a BMI of 24, healthy, with no pathological history, due to axial lumbar pain and left radicular VAS 8/10, a 6-month evolution (ODI) of 62%, with intensification in the last month. Go with panoramic X-ray images of the spine, MRI and CT Diagnosis: left thoracolumbar degenerative scoliosis. It is classified according to SRS-Schwab (curve: L, PI-LL [0], GA-SVA [0], PT [+]), Rossouly (4) COBB: 36.7°. Treatment: scoliosis correction, mixed XLIF T12 to L⁴, pedicle screws of T9-S1 with Navigation O-ARM & Stealth Station, (TLIF) of L⁵-S1 and posterolateral fusion. Conclusion: In the present case, by means of indirect XLIF decompression and with TLIF supported by Neuromonitoring and Navigation, it was possible to correct curves and compression without complications or failure in screw placement even with distorted anatomy, we recommend replacing the use of C-ARM in screw placement by Navigation with O-ARM. Use of XLIF TLIF and Posterior Fusion with Neuromonitoring and Navigation is ideal in these deforming cases since it shows us a 3D image in real time unlike C-ARM presenting 20% complications, so it is recommended in the event of loss of anatomy It is normal to use navigation with complications, these being not serious.

REFERENCES

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