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This film demonstrates how to perform a minimal-invasive lumbar fusion with percutaneous pedicle screw placement and minimal-invasive release of lumbar instability. In addition this film shows how to achieve targeted coronal and sagittal balance with both minimal-invasive multi segmental osteotomies and a Smith Peterson Osteotomy.
The patient is a 52-year-old female with a history of persistent pain after a L4/5 discectomy in 2011. She complains of progressive mechanical low back pain with a L5 sensory radiculopathy. Standing X-rays of the lumbar spine in ap and lateral show L4/5 and L5/S1 disk space narrowing with loss of lumbar lordosis. MRI show a neuroforaminal stenosis at L4/5 und L5/S1.