A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation
The anterior lumbar interbody fusion (ALIF) is a well-established procedure used to treat a multitude of spinal pathologies. When performed at the L5-S1 level, the ALIF is often supplemented with posterior pedicle screw and rod fixation. Because the interbody device can restore disk and foraminal he...
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Wiley
2021-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2021/5514720 |
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| author | Matthew T. Neal Maziyar A. Kalani Mark K. Lyons |
| author_facet | Matthew T. Neal Maziyar A. Kalani Mark K. Lyons |
| author_sort | Matthew T. Neal |
| collection | DOAJ |
| description | The anterior lumbar interbody fusion (ALIF) is a well-established procedure used to treat a multitude of spinal pathologies. When performed at the L5-S1 level, the ALIF is often supplemented with posterior pedicle screw and rod fixation. Because the interbody device can restore disk and foraminal height, one benefit of the ALIF procedure is indirect neural decompression in the spinal canal and neural foramina. If the contour of the posterior rod is not matched to the exact position of the tulip heads on the pedicle screws, spondylolisthesis can be introduced, leading to foraminal stenosis and nerve compression. This concern is particularly germane when the posterior instrumentation is placed percutaneously without any direct foraminal decompression. In this report, we describe a patient who had an L4-S1 ALIF, resulting in new L5-S1 retrolisthesis and worsening L5 radiculopathy. Technical nuances and avoidance strategies are discussed. |
| format | Article |
| id | doaj-art-44c4158eecc342a9b4df53d434c3aa86 |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-44c4158eecc342a9b4df53d434c3aa862025-02-03T01:28:14ZengWileyCase Reports in Orthopedics2090-67492090-67572021-01-01202110.1155/2021/55147205514720A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior InstrumentationMatthew T. Neal0Maziyar A. Kalani1Mark K. Lyons2Department of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Neurologic Surgery, Mayo Clinic College of Medicine and Science, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USAThe anterior lumbar interbody fusion (ALIF) is a well-established procedure used to treat a multitude of spinal pathologies. When performed at the L5-S1 level, the ALIF is often supplemented with posterior pedicle screw and rod fixation. Because the interbody device can restore disk and foraminal height, one benefit of the ALIF procedure is indirect neural decompression in the spinal canal and neural foramina. If the contour of the posterior rod is not matched to the exact position of the tulip heads on the pedicle screws, spondylolisthesis can be introduced, leading to foraminal stenosis and nerve compression. This concern is particularly germane when the posterior instrumentation is placed percutaneously without any direct foraminal decompression. In this report, we describe a patient who had an L4-S1 ALIF, resulting in new L5-S1 retrolisthesis and worsening L5 radiculopathy. Technical nuances and avoidance strategies are discussed.http://dx.doi.org/10.1155/2021/5514720 |
| spellingShingle | Matthew T. Neal Maziyar A. Kalani Mark K. Lyons A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation Case Reports in Orthopedics |
| title | A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation |
| title_full | A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation |
| title_fullStr | A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation |
| title_full_unstemmed | A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation |
| title_short | A Technical Nuance to Avoid Lumbar Five Radiculopathy with Anterior Lumbar Fusion and Posterior Instrumentation |
| title_sort | technical nuance to avoid lumbar five radiculopathy with anterior lumbar fusion and posterior instrumentation |
| url | http://dx.doi.org/10.1155/2021/5514720 |
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