• World Neurosurg · Nov 2017

    Case Reports

    Rescue implantation of expandable cages for severe osteolysis and cage dislocation in the lumbosacral junction.

    • Bawarjan Schatlo, Veit Rohde, Volodymyr Solomiichuk, Kajetan von Eckardstein, and Timo Behm.
    • Department of Neurosurgery, University Hospital Göttingen, Georg-August-University, Göttingen, Germany.
    • World Neurosurg. 2017 Nov 1; 107: 1049.e13-1049.e17.

    BackgroundOsteolysis and implant loosening are commonly encountered problems after spinal instrumentation.Case DescriptionIn a patient who had previously undergone a posterior lumbar interbody fusion procedure, fusion did not occur, and a secondary cage dislocation led to an impingement of the L5 nerve root with severe radiculopathy. Revision surgery was performed. Intraoperatively, osteolysis was found to be so severe that conventional cages did not fill the void to allow for sufficient anterior column support. We used expandable transforaminal lumbar interbody fusion cages and implanted them bilaterally to replace the dislodged posterior lumbar interbody fusion cages. Clinical follow-up was uneventful. Imaging performed at 1 year showed satisfactory cage position and fusion.ConclusionsWe propose the use of cages with the ability of ventral distraction in similar rescue interventions with cage dislocation and bone resorption. This may prevent a second surgery via a ventral approach.Copyright © 2017 Elsevier Inc. All rights reserved.

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