Lumbar disease case
Grade 1 L4/5 Lumbar Spondylolisthesis and Spinal Stenosis causing severe compression to cauda equina nerves
Age: 87 years old lady
- Back pain
- Severe pain, numbness at legs during daytime and during sleep.
- Legs weakness at both sides, episodes of fell at home and at streets.
- Frequency in urination & constipation.
- Symptoms lead to disturbed emotion, bad morale.
- Home bounded, loss of opportunity of walking out home and loss of social activities.
4 hours of Minimally Invasive Spine Neurosurgery:
L4/5 Transforaminal Lumbar Interbody Fusion (TLIF) + Decompressive Laminectomy:
Continuous Intraoperative Nerves Monitoring, so as to sure the safety & the effectiveness of surgery
Objectives of surgeries:
- Fusion surgery to revert the spine slipping and to stabilize the spine in order to alleviate her back pain.
- Nerves decompressive surgery to free the cauda equina nerves so as to eliminate the numbness & pain at legs, and to improve the strength at legs, also to improve the urinary and bowel habit.
- The old lady immediate felt no more pain & numbness at legs. Legs were strong in power. She could walk in a more erect normal posture and in a steady gait.
- There was no more urinary frequency & no more constipation.
- She showed improved morale & mood with smiling faces upon hospital discharge and clinic follow up.
- 3 mini-wounds healed well. Follow-up X ray, CT scan and MRI revealed that the spondylolithesis of spine
was being corrected, all implants are in ideal positions, the compressed cauda equina nerves were all freed.