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Failure of
Flexible Stabilization
Case Presentation |
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Shown above are MRI images of a patient presenting with incapacitating
low back and leg pain. Mild multi-level degenerative changes
consistent with an underlying genomic spine condition are present in
addition to a G1 degenerative spondylolisthesis (red dot). This
listhesis is producing a central spinal stenosis (center image). In
addition there is discal bulge into the left intervertebral foramen (A), a
discal herniation into the foramen at L4-5 with resulting lateral spinal
stenosis (B), and lateral spinal stenosis at L5-S1 secondary to a superior
articular facet syndrome (C). |
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As the method of surgical treatment a Dynesys flexible stabilization
system was placed from L4 to L5 levels. The image to the right shows
that no decompression of stenosis was performed. |
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This patient was not improved following placement of flexible
stabilization system. It was removed and then replaced with a rigid
segmental instrumentation system as shown. There has also been a
laminectomy at the L4, but not the L5 level. The patient has
continued to have significant problems. |
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The case presented was a treatment failure. The reason for this
was not related to the employment of a flexible stabilization but upon
failure to address the primary need for adequate nerve decompression prior
to considering any form of stabilization. Another example of the
relationship between a carpenter and a
nail. |
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