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- Nuvasive
- Orthofix
- Medtronic
- K2m
MIS Spine Surgery: Complications and Avoidance Lessons Learned - - PowerPoint PPT Presentation
MIS Spine Surgery: Complications and Avoidance Lessons Learned - - PowerPoint PPT Presentation
MIS Spine Surgery: Complications and Avoidance Lessons Learned Nuvasive Orthofix Medtronic K2m Retrospective study Cobb angle: 25 patients (2-8 levels) Preop 21.1 (10 48 ) Showed inadequately
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- Retrospective study
- 25 patients (2-8 levels)
- f/u mean 11 months (3-20)
- 2 stages
- MIS techniques:
– Lateral (XLIF™ ) – Presacral (AxiaLIF™) – Mini-open TLIF – Perc. pedicle screw – Lat plate
- Cobb angle:
– Preop 21.1° (10–48°) – Post op 6.4° (1–24°).
- VAS: 5.7 impr.
– Preop 8.1 – Post op 2.4
- ODI impr 23.7%
- No pseudoarthrosis
- Sagittal balance
Showed inadequately restored sagittal balance on 1/3 of cases.
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ACR
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Intradiscal vacuum Phenomenon
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Stage
Preop Postop 1st stage
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Fractional Curve
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Fractional Curve
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TLIF vs ALIF L5/S1
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Facet Hypertrophy
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Rotational component and curve magnitud
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Rotational component and curve magnitud
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In situ Bending
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PI: 56 PT: 29 LL: 31 SVA: 7 Coronal: 30 CSVL: 2 78 y/o F . LBP 90% Intractable LBP, 10% LLE pain. VAS 8. Neurologically intact.
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Strategies to Prevent/Manage Complications
1. Better understanding of ASD 2. High PI worst MIS enemy 3. Limitations of MIS techniques 4. Stage 5. Interspace vacuum air 6. Facet Hypertrophy 7. Rotational component 8. Fractional Curve 9. Importance of L5/S1
- 10. Anterior column manipulaiton
- 11. In situ bending
- 12. ALIF better than TLIF
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- Significant challenges exist, as the surgical
technique does not yet allow for all correction maneuvers used in open surgery.
- MIS is not better than OPEN Techniques.