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Research ArticleEndoscopic Minimally Invasive Surgery

Feasibility of Full Percutaneous Segmental Stabilization of the Lumbar Spine With a Combination of an Expandable Interbody Cage and an Interspinous Spacer: Preliminary Results

RUDOLF MORGENSTERN and CHRISTIAN MORGENSTERN
International Journal of Spine Surgery December 2018, 12 (6) 665-672; DOI: https://doi.org/10.14444/5083
RUDOLF MORGENSTERN
Morgenstern Spine Institute, Centro Médico Teknon, Barcelona, Spain
MD, PHD
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CHRISTIAN MORGENSTERN
Morgenstern Spine Institute, Centro Médico Teknon, Barcelona, Spain
MD, PHD
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    Figure 1

    (a) In the sagittal plane, the interspinous implant limits segmental movement during extension (arrows) of the upper body by restricting movement of the posterior column of the operated level. (b) In the coronal plane, the interbody cage limits lateral bending (see arrows) in the operated level. (c) The percutaneous approach preserves the facets that restrict rotation (see arrows) of the operated level. Note how the interbody cage is correctly placed over the midline of the intervertebral disk in the axial plane.

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    Figure 2

    (a) Preoperative magnetic resonance imaging sagittal images of the lumbar spine of a female patient with degenerative disc disease and osteoarthritic changes (Modic II) at L3 to L4 and L4 to L5. (b) Postoperative computed tomography scan of the lumbar spine with an expandable cage and a percutaneous interspinous spacer at L3 to L4 and L4 to L5, respectively. (c) All 4 implants were percutaneously introduced through 1 single skin incision of 15 mm.

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    Figure 3

    Outcome distribution according to modified Macnab criteria for 16 cases.

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    Figure 4

    Incidental finding in the routine postoperative 4-week X-ray control (b) of subsidence of the expandable cage with osteointegration into the inferior end plate of the superior vertebra in comparison to the immediate postoperative computed tomography scan (a). The patient has been clinically asymptomatic and reports no pain.

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    Figure 5

    Female patient with severe osteoporosis presenting fractured L3 and L4 spinous processes after a 3-year follow-up.

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International Journal of Spine Surgery
Vol. 12, Issue 6
1 Dec 2018
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Feasibility of Full Percutaneous Segmental Stabilization of the Lumbar Spine With a Combination of an Expandable Interbody Cage and an Interspinous Spacer: Preliminary Results
RUDOLF MORGENSTERN, CHRISTIAN MORGENSTERN
International Journal of Spine Surgery Dec 2018, 12 (6) 665-672; DOI: 10.14444/5083

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Feasibility of Full Percutaneous Segmental Stabilization of the Lumbar Spine With a Combination of an Expandable Interbody Cage and an Interspinous Spacer: Preliminary Results
RUDOLF MORGENSTERN, CHRISTIAN MORGENSTERN
International Journal of Spine Surgery Dec 2018, 12 (6) 665-672; DOI: 10.14444/5083
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Keywords

  • expandable interbody cage
  • interspinous spacer
  • percutaneous surgery
  • percutaneous transforaminal lumbar interbody fusion

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