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Lumbar Spinal Fixation Removal by a Minimal Invasive Microscope-Assisted Technique. Case Report with Technical
Giovanni Grasso1, Saverio Paolini1, Marcello Sallì2
1Neurosurgical Unit, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy.
Abstract:
The concept of minimally invasive spine surgery (MISS) has gained increasing popularity in the last decades. While MISS holds promise for faster patient recovery, and shorter hospital stays, the removal of the surgical fixation, when required, is still performed by an extensive approach often resulting in disabling pain and discomfort. We describe a novel minimal invasive microscope-assisted technique for lumbar spinal fixation removal. This technique has been successfully applied in a 35-year-old man, affected by back pain despite a previous posterior dynamic MISS L4-S1 fixation. The previous skin incisions were opened and under microscopic vision, the screws and the roads were dissected from the scars and removed. The patient was discharged on postoperative day-1. He reported a progressive improvement of the symptoms with a satisfactory cosmetic result. Minimal invasive microscope-assisted technique for spinal fixation removal offers a simple and effective surgical alternative to the traditional open surgery.
Insights
Minimally invasive spine surgery (MISS) fixation removal can now be done with a novel microscope-assisted technique. This approach offers a less painful and more effective alternative to traditional open surgery for patients.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
Background:
- Minimally invasive spine surgery (MISS) is increasingly popular, offering benefits like faster recovery.
- However, removal of spinal fixation after MISS often requires extensive open surgery, causing significant pain.
Observation:
- A novel microscope-assisted technique for minimally invasive lumbar spinal fixation removal was developed.
- This technique was successfully used in a patient with persistent back pain after prior MISS L4-S1 posterior dynamic fixation.
Findings:
- The procedure involved reopening previous small incisions and dissecting screws and rods under microscopic vision.
- The patient was discharged on postoperative day 1 and reported progressive symptom improvement.
- A satisfactory cosmetic outcome was achieved.
Implications:
- This minimally invasive microscope-assisted technique provides a simple, effective alternative to open surgery for spinal fixation removal.
- It may reduce patient pain and discomfort associated with hardware removal after MISS.
- Further studies could explore wider application and long-term outcomes.
