Spine fixation in osteoporotic patient- Dr Anil kothiwala Neurosurgeon Jaipur

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“Neurosurgery in octagenerians.”

Instrumented ligamentotaxis and stabilisation is standard treatment for thoracolumbar junction injuries with TLICS >4. In this case patient is Great grand mother with cardiac history and severe osteoporosis (weak bones). Cardiology clearance achieved after stable stress echo Using Dobutamin. We used hydroxyapatite coated screws which improves grasp of pedicel screws in osteoporotic bone. For distraction reduction of fracture segment we used spinous process for anchor as Application of distraction force over Pedicle screws might dislodge them in osteoporotic situation. Surgeon’s proprioception guides in this manoeuvre. Involving the fractured vertebrae in construct, further consolidates the strength & gives us liberty to keep fixation at less levels and preserves mobility.

Due to covid restrictions they can’t travel from their city but they informed me that she is independent in her activities and symptoms free.
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