Discusión entre pares / 25yrs old female,with l1 f,how many level must be fixed? Without neurological defection

25yrs old female,with l1 f,how many level must be fixed? Without neurological defection
  • Saankritya Ayan I wud do 2 up yo down . Junctional area , calls for meticulous contouring.

  • Swetabh Verma Lucky pt to have escaped neurodeficits..this is an unstable fracture for sure and a ct would reveal retropulsion to cAnal..although even 70% canal compromise is ok sometimes, yet fixing the fracture atleast 2 level up and down would provide the much needed stability..not much role of any anterior column support by bone graft/ cage..posterior ligament repair would ensure a healthy tension band and much needed stability for early ambulation of pt..plz do get a CT also before proceeding

  • Kedar Phadke So we get a CT, plan 2 up 2 down. No cage/bg?

  • Swetabh Verma Planning for a facetal fusion, pushing some bone graft anteriorly would b more wise than doing a challenging surgery like expandable/ mesh cage..moreover the pt is neurologically intact..

  • Swetabh Verma Even to plan any anterior column support we need a ct for applying mc cormack and gaines classfn..still i feel this pt would do equally good if only posterior fixation and fusion is attempted

  • Kedar Phadke Yup I agree. CT is a must. And only posterior

  • Vedant Vaksha If no neuro deficit, only post fusion is ok. If u get a good purchase in L1 b/l pedicles, stopping at L2 may be sufficient. Going to L3 will also not be very detrimental!!

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