Interbody Fusion Lab Report
4.3. Pre-operative preparation
Pre-operative routine examination and investigations were done in all patients. These included complete blood count (CBC), magnetic resonance imaging (MRI), electrocardiogram (ECG), liver function test (LFT), serology, renal function test (RFT), X-ray Lumbar spine anterior–posterior and lateral views, chest x-ray anterior–posterior view, and computed tomography scanning (CT). Preoperative Prophylactic antibiotics were given to the Patients to diminish infection chances.
4.4. Surgical techniques:
Before starting Interbody fusion or Circumferential Fusion procedure patients were placed properly on Wilson frame in prone position. Preoperative antibiotic cefazolin 2 gram was given intervenously. Under fluoroscopic …show more content…
Interbody fusion: In case of interbody fusion midline approach is preferred. In this approach exposer is very less which is from lateral to facets due to its intended fusion surface. In this process infra and supraspinous ligaments were taken out and then ligament of falvum was lifted from inferior laminas surface at lower side of cephalad lamina by using curette.
To performe Partial facetectomies, a burr and Kerrison rongeurs were used to create hemilaminectomy opening to the vertebral disc. Laterally ligament of flavum was released from the facets, cauded and cephalad from the laminas, then retraction of medially based flap against dura which is protacting traversing root of nerve, it is protected underneath the ligamentum flavum flap. Using a blade sizes 15 annulotomy defect was created. To remove exposed bleeding and materials of disc curettes, shavers and Pituitaries were used. There was a bone funnel placed in the space of disc. Through autograft laminectomized and microparticulate demineralized bone matrix at the anterior longitudinal ligament bone were filled. Through the annular opening TLIF/PLIF polyetheretherketone cage was placed, till graft was tightly …show more content…
After removing facets and ligamentum flavum complete decompression was achieved. After this all procedure we can observe lumber spine is settled into lordosis and the Wilson frame was taken out of kyphosis. Finally Pedicle screw fixation was placed over the facets. Then wound was cleaned and incision was closed in interrupted layers. In some surgical procedures we put drain and in some we don’t.
4.4.2. Circumferential Fusion: In case of Circumferential Fusion first of patient was placed on a radiolucent spine table. If Kyphosis was detected in any case Manipulative reduction was applied. By the help of Fluoroscope fractured vertebral body was located. In this procedure also posterior midline approach was prefared with midline straight incision at the centar of the affected lavel and leminae was exposed. Both side of facet joint was exposed with the help of electric cuter. At the level of below and above fractured vertebral body Pedicle screws were introduced [42, 43].
In case of intact pedicle to decompress the posterior aspect of the thecalsac both laminae and Spinal process at the affected level are removed by
Pre-operative routine examination and investigations were done in all patients. These included complete blood count (CBC), magnetic resonance imaging (MRI), electrocardiogram (ECG), liver function test (LFT), serology, renal function test (RFT), X-ray Lumbar spine anterior–posterior and lateral views, chest x-ray anterior–posterior view, and computed tomography scanning (CT). Preoperative Prophylactic antibiotics were given to the Patients to diminish infection chances.
4.4. Surgical techniques:
Before starting Interbody fusion or Circumferential Fusion procedure patients were placed properly on Wilson frame in prone position. Preoperative antibiotic cefazolin 2 gram was given intervenously. Under fluoroscopic …show more content…
Interbody fusion: In case of interbody fusion midline approach is preferred. In this approach exposer is very less which is from lateral to facets due to its intended fusion surface. In this process infra and supraspinous ligaments were taken out and then ligament of falvum was lifted from inferior laminas surface at lower side of cephalad lamina by using curette.
To performe Partial facetectomies, a burr and Kerrison rongeurs were used to create hemilaminectomy opening to the vertebral disc. Laterally ligament of flavum was released from the facets, cauded and cephalad from the laminas, then retraction of medially based flap against dura which is protacting traversing root of nerve, it is protected underneath the ligamentum flavum flap. Using a blade sizes 15 annulotomy defect was created. To remove exposed bleeding and materials of disc curettes, shavers and Pituitaries were used. There was a bone funnel placed in the space of disc. Through autograft laminectomized and microparticulate demineralized bone matrix at the anterior longitudinal ligament bone were filled. Through the annular opening TLIF/PLIF polyetheretherketone cage was placed, till graft was tightly …show more content…
After removing facets and ligamentum flavum complete decompression was achieved. After this all procedure we can observe lumber spine is settled into lordosis and the Wilson frame was taken out of kyphosis. Finally Pedicle screw fixation was placed over the facets. Then wound was cleaned and incision was closed in interrupted layers. In some surgical procedures we put drain and in some we don’t.
4.4.2. Circumferential Fusion: In case of Circumferential Fusion first of patient was placed on a radiolucent spine table. If Kyphosis was detected in any case Manipulative reduction was applied. By the help of Fluoroscope fractured vertebral body was located. In this procedure also posterior midline approach was prefared with midline straight incision at the centar of the affected lavel and leminae was exposed. Both side of facet joint was exposed with the help of electric cuter. At the level of below and above fractured vertebral body Pedicle screws were introduced [42, 43].
In case of intact pedicle to decompress the posterior aspect of the thecalsac both laminae and Spinal process at the affected level are removed by