Sagittal Imbalance (kyphosis) – 55 yo male with sagittal malalignment s/p prior fusion procedures


55 yo male with lumbar DDD s/p multiple lumbar fusion procedures and sagittal malalignment and disabling back pain.

 

Pre-operative AP and LAT X-ray:
HBpreopAP e1511187750459 225x300 - Sagittal Imbalance (kyphosis) - 55 yo male with sagittal malalignment s/p prior fusion proceduresHBpreoplat 2 e1511187774195 225x300 - Sagittal Imbalance (kyphosis) - 55 yo male with sagittal malalignment s/p prior fusion procedures

 

He was treated with TL reconstruction T10-LS fusion mass with subsequent fracture through the fusion mass at L4 and progressive kyphotic deformity.

 

 Lateral X-ray demonstrating L4 fracture and progressive kyphotic deformity:
HB.Lat .preop2  224x300 - Sagittal Imbalance (kyphosis) - 55 yo male with sagittal malalignment s/p prior fusion procedures

 

The patient was treated with revision reconstruction from T10 to the ilium with asymmetric vertebrectomy L4 to correct the kypho-scoliotic deformity. The patient developed postoperative radiculopathy with weakness that improved over the ensuing 9 months with marked improvement in pain, functional abilities, and ADL.

 

Post-operative AP and LAT X-ray:
HB.AP .postop 245x300 - Sagittal Imbalance (kyphosis) - 55 yo male with sagittal malalignment s/p prior fusion proceduresHB.Latpostop 2 118x300 - Sagittal Imbalance (kyphosis) - 55 yo male with sagittal malalignment s/p prior fusion procedures