Wednesday, September 12, 2007

Hey Clinic AM Sep 12 2007 Surgery: L1-S1-Iliac Wing reconstruction in woman with severe spondylolisthesis and stensosis

I just finished doing surgery on a Mildred, lady who had prior laminectomy
for lumbar spondylolisthesis, who had severe progressive back and leg pain,
and severe difficulty walking. Her X-Rays showed a degenerative scoliosis with severe spondylolisthesis. Her MRI showed severe multilevel spinal stenosis L1-L5. She underwent L1-Iliac wing reconstruction today with hardware as shown. The stenosis was very tight at multiple levels including where she had laminotomies at L45. Her laminectomy was 5 levels, L1-5, and was more complex due to previous laminectomy surgeries. Surgery was 4 hours 15 minutes. EBL 2300 cc. 1000 cc Cell Saver and 1 unit PRBC transfused. She did well with anesthesia.

In general it is better to do instrumentation and fusion if there is a spondylolisthesis or scoliosis to prevent further slippage and/or collapse with recurrance of stenosis.

This woman will walk and stand much better. Notice how I preserved her lumbar lordosis, which helps her to stand up straight. Her scoliosis from preop is well corrected.

Lloyd A Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC -- USA

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