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Modified S1 Pedicle Subtraction Osteotomy – Lumbar Fusion

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The article discusses a surgical technique video that focuses on revising patients with previous fusions at L4-S1 that result in an iatrogenic flat back and sagittal imbalance. The technique involves using L5-S1 transforaminal interbody fusion combined with a small S1 corner osteotomy. The case study presented is of a 51-year-old woman with a history of multiple lumbar surgeries, severe back pain, sagittal imbalance, and loss of lordosis. The revision technique aims to restore lumbar lordosis and sagittal balance through a modified S1 pedicle subtraction osteotomy and the use of an interbody cage to enhance fusion rate. The results showed significant improvement in the patient’s lordosis angle postoperatively. The article concludes that the combination of L5-S1 transforaminal interbody fusion and S1 corner osteotomy is a feasible technique for restoring lumbar lordosis in patients with previous fusions

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spine centre in the world

Published article

: The combination of L5-S1 transforaminal interbody fusion and S1 corner osteotomy is a feasible technique for the restoration of lumbar lordosis in patients with previous fusion and consequent loss of lordosis.

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Clin Spine Surg. 2024 Apr 16. doi: 10.1097/BSD.0000000000001620. Online ahead of print. ABSTRACT STUDY DESIGN: Surgical technique video. OBJECTIVE: To report a surgical technique to revise patients with previous fusions at L4-S1 leading to an iatrogenic flat back and sagittal imbalance using L5-S1 transforaminal interbody fusion combined with a small S1 corner osteotomy. BACKGROUND: This,

Clin Spine Surg. 2024 Apr 16. doi: 10.1097/BSD.0000000000001620. Online ahead of print.

ABSTRACT

STUDY DESIGN: Surgical technique video.

OBJECTIVE: To report a surgical technique to revise patients with previous fusions at L4-S1 leading to an iatrogenic flat back and sagittal imbalance using L5-S1 transforaminal interbody fusion combined with a small S1 corner osteotomy.

BACKGROUND: This is a case of a woman (51 y old) with a history of multiple lumbar surgeries, severe back pain, sagittal imbalance, and loss of lordosis.

METHODS: We describe a feasible revision technique in a complex patient with the goal of attaining optimal distribution of lumbar lordosis and sagittal balance through a modified S1 pedicle subtraction osteotomy, and the use of an interbody cage to enhance the fusion rate and facilitate closure of the 3-column osteotomy.

RESULTS: The preoperative patient lordosis angle of 31 degrees at L1-L4 and 16 degrees at L4-S1 became 12 degrees at L1-L4 and 44 degrees at L4-S1 postoperatively.

: The combination of L5-S1 transforaminal interbody fusion and S1 corner osteotomy is a feasible technique for the restoration of lumbar lordosis in patients with previous fusion and consequent loss of lordosis.

PMID:38637935 | DOI:10.1097/BSD.0000000000001620

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Modified S1 Pedicle Subtraction Osteotomy

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Clin Spine Surg. 2024 Apr 16. doi: 10.1097/BSD.0000000000001620. Online ahead of print. ABSTRACT STUDY DESIGN: Surgical technique video. OBJECTIVE: To report a surgical technique to revise patients with previous fusions at L4-S1 leading to an iatrogenic flat back and sagittal imbalance using L5-S1 transforaminal interbody fusion combined with a small S1 corner osteotomy. BACKGROUND: This

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