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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6040_Библиотеки_им_академика_М_И_Перельмана.pdf
160 T. Popolizio et al.
Postoperative Follow-Up
Fig. 2 XR sagittal.
Regular positioning of
metallic device
Degenerative Lumbar Instability Rigid Posterior Stabilization
Regular Findings
Tommaso Scarabino, Saverio Pollice, Marianna Schiavariello,
Carmine Iaffaldano and Raniero Mignini
Preoperative Imaging
Case
47
• Patient with back pain wich extends in lower limbs and neurogenic
claudicatio in L4-L5 degenerative anterolisthesis treated by posterior
rigid stabilization and intervertebral prosthesis posteriorly placed
(Posterior Lumbar Fusion Surgery, PLIF)
• Early XR preoperative imaging and postoperative follow-up
Fig. 1 a–b. Dynamic XR
lateral max flexion (a) and
max extension (b).
Anterolisthesis L4–L5
mostly appreciable in max
flexion (a)
T. Scarabino S. Pollice M. Schiavariello
Department of Radiology—Neuroradiology, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
C. Iaffaldano R. Mignini (&)
Department of Neurosurgery, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
e-mail: ranieromignini@libero.it
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_52, Springer-Verlag Italia 2014
161
162 T. Scarabino et al.
Early Postoperative Follow-Up
Fig. 2 a–c. XR anteroposterior (a) and lateral (b, c). Regular positioning of device. c radio-opaque markers at L4–L5
Lumbar Stenosis and Degenerative Instability Posterior Rigid Stabilization
Regular Findings
Tommaso Scarabino, Angela Lorusso, Pietro Maggi,
Carmen Bruno and Raniero Mignini
Preoperative Imaging
Fig. 1 a-c.SET1(a),
FSE T2 (b), STIR
(c) sagittal. Severe
congenital stenosis with
L4–L5 disk height
reduction
Case
48
• Patient with low-back pain in stenosis and vertebral instability treated
by rigid posterior stabilization and intervertebral prosthesis
posteriorly placed with trans-foraminal approach
(Transforaminal Lumbar Interbody Fusion Surgery, TLIF)
• MR preoperative imaging and early XR postoperative follow-up
T. Scarabino A. Lorusso P. Maggi
Department of Radiology—Neuroradiology, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
C. Bruno R. Mignini (&)
Department of Neurosurgery, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
e-mail: ranieromignini@libero.it
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_53, Springer-Verlag Italia 2014
163
164 T. Scarabino et al.
Early Postoperative Follow-Up
Fig. 2 a-b. XR anteroposterior (a) sagittal (b).
Regular positioning of device
Degenerative Lumbar Instability Rigid Posterior Stabilization
Regular Findings
Case
49
Luigi Manfre
• Patient with bilateral neurogenic claudicato and sciatic pain in L5
• CT preoperative imaging and postoperative follow-up
Preoperative Imaging
`
dermatometer in L5-S1 listhesis treated by percutaneous posterior
CT-guided stabilization through transpeduncular screw at L4, L5,
and S1 (45 mm) and bars (60 mm)
Fig. 1 a–c. CT. MPR Sagittal bone window (a), Soft tissue window (b), 3D (c). I L5 anterolisthesis with L5-S1
foraminal stenosis
L. Manfrè (&)
Department of Neuroradiology, ‘‘Cannizzaro’’ Hospital, Catania, Italy
e-mail: lmanfre@me.com
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_54, Springer-Verlag Italia 2014
165
166 L. Manfre
Intraoperative Imaging
Fig. 2 Percutaneous CT-guided stabilization with screws and bars determines posterior traction on L4 and slight
distraction to reopening L5-S1 foramen
Postoperative Follow-Up
`
Fig. 3 a–c. CT. MPR bone window sagittal (a–b), 3D (c). Reduction of L5 listhesis, foramen expansion, and
disappearance of symptoms in 2 weeks
Degenerative Lumbar Instability Stabilization
Junctional Syndrome
Mario Muto, Gianluigi Guarnieri and Roberto Izzo
• Patient with low back pain in vertebral instability treated
by L3–L5 stabilization
• Early and late XR/CT postoperative follow up (3 years)
Early Postoperative Follow-up
Fig. 1 a–b. XR lateral
and anteroposterior.
Dynamic acquisitions
under fluoroscopy show
regular lumbar stability
Case
50
M. Muto (&) G. Guarnieri R. Izzo
Department of Neuroradiology, Cardarelli Hospital, Naples, Italy
e-mail: mutomar@tiscali.it
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_55, Springer-Verlag Italia 2014
167
168 M. Muto et al.
Postoperative Follow-up After 3 years
Fig. 2 a–b. Sagittal MPR L2–L3 junctional syndrome
Stop of Contrast Media in L2–L3
Fig. 3 a–b. Myelography: lateral and anteroposterior.
Degenerative Lumbar Instability Rigid Posterior Stabilization
Device Infection
Ferdinando Caranci, Achille Marotta, Domenico Cicala
and Francesco Briganti
• Patient with pain in vertebral instability and I grade L5-S1 listhesis
treated by posterior stabilization through L4-S1 trans-peduncular
screws
• CT/MR postoperative follow-up after 1 and 6 months; MR evaluation
after device removal 3 months later
Postoperative Follow-Up After 1 Month
Case
51
Fig. 1 a–e. STIR sagittal (a–c), fat sat SE T1 coronal (d) and CE coronal (e) sections. T2 hyperintensity of
retrovertebral muscles due to edema and flogosis caudally extending until sacrum bone. CE in the superior part of
stabilization device (e)
F. Caranci (&) F. Briganti
Advanced Biomedical Sciences Department, Unit of Neuroradiology,
Federico II University, Naples, Italy
e-mail: ferdinandocaranci@libero.it
A. Marotta D. Cicala
Unit of Diagnostic Imaging, Villa Fiorita Clinic, Capua, CE, Italy
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_56, Springer-Verlag Italia 2014
169