Upload
nicola-zullo
View
59
Download
0
Tags:
Embed Size (px)
Citation preview
XLIF® Case Review
Zullo Nicola M.D.
Male, 83 years
3 year low back pain
Failed conservative therapy
Physical exam positive for radiculopathy (claudicatio 100 m)
Severe stenosys on MRI and spondilolistesys L3L4 and L4-L5
No pain using bicycle
Inability to stand supine position
[Case #1, Pre-op]
[Case #1]
[Case #1]
L2-L3
L3-L4
[Case #1]
Left Foraminal view Right Foraminal view
[Case #1]
L3-L4
L2-L3
L4-L5
NRS Back 7
NRS Leg 7
ODI 47
Pre - operative
3 Days post - operative
3 Months post - operative
NRS Back 2
NRS Leg 4
ODI 9
3 Months post - operative
6 Months post - operative
6 Months post - operative
NRS Back 2
NRS Leg 2
ODI 6
Female, 84 years
4 year low back pain
Failed conservative therapy
Physical exam positive for radiculopathy (claudicatio 300 m)
Severe stenosys on MRI at L4-L5
2009 Vertebroplasty L1
Pre - operative
NRS Back 9
NRS Leg 6
ODI 51
[Case #3, Pre-op]
Intra- operative
Intra- operative
3 Days post - operative
3 Months post - operative
NRS Back 5
NRS Leg 5
ODI 16
3 Months post - operative
6 Months post - operative
NRS Back 5
NRS Leg 5
ODI 38
6 Months post - operative
Female, 76 years
5 year low back pain
Failed conservative therapy
Physical exam positive for radiculopathy (claudicatio 100 m)
Stenosys on MRI and spondilolistesys L4-L5
Diabetes
Osteoporosis
Pre - operative
NRS Back 7
NRS Leg 8
ODI 49
PI 53°
PT 19°
LL 71°
3 Days post - operative
3 Months post-operative
3 Months post-operative
NRS Back 3
NRS Leg 3
ODI 12
Male, 43
10 year low back pain with some radicular left leg pain
Failed conservative therapy
Physical exam negative for radiculopathy
No root compression on MRI
No comorbidities
Pre - operative
NRS Back 8
NRS Leg 4
ODI 34
3 Days post - operative
1 month post-op
3 months post-op
3 Months post - operative
NRS Back 1
NRS Leg 1
ODI 18
• Male 42 YO, obesity, building industry worker
• two years low back pain with right mild L5 raduclopaty
• Failed conservative therapy• L4-L5 Degenerative disc disease
Modic 2 Pfirrmann IV with associated spinal canal narrowing
• No clear nerve root compression on MRI
• Physical exam: mild right radiculopaty, sever low back pain
• No significant co-morbidities
Pre-operative assessment
NRS back 8
NRS Leg 2
ODI 32/50
Pre-operative imaging
Pre-operative imaging
L4-L5 L5-S1
SPINO-PELVIC ASSESSMENT
PT 40°
PI 20°
LL 12°
C7 PL midpoint S1 plate
1 month post-op X-ray
Three months CT scan
Three month post-op. assessment
NRS Back 1
NRS Leg 0
ODI 0/50