flat back case
DESCRIPTION
Case : Flat back / Revision surgeryTRANSCRIPT
Flatback Syndrome
Ricardo Ferreira, MDRafael Mota, MD
Rio de JaneiroBrazil
RCPV
• 35 year old female• One prior scoliosis surgery ( > 20 Y post-op )• Decompensated forward• Leg / Back pain • Progressive neurogenic claudication
Flat Back
X-Ray
CT
MRI
Flat Back
What we gonna do now ?
I had planned ...• Removal of Harrington rod• L4-5, L5-S1 Laminectomy• Osteotomy of facets and release the old fusion • T4-S1 Pedicular fixation (pedicle screws, rods and hooks)
• Correction to achieve spinal balance• Placement of bone graft
But...After massive blood loss during rod removal and osteotomies
A new surgical strategy :– Removal of Harrington rod – L4-5, L5-S1 Laminectomy– Osteotomy of facets and release of the old fusion ( JUST LUMBAR ) – L1-S1 Pedicular fixation (pedicle screws, rods )
– Correction to increase lumbar lordosis and pelvic balance – Placement of bone graft
In Loco
Post – op
Before & After
Before Before After After
Before & After
Before After
Before & After
Before After