First long-segment 3D navigated MIS spinal reconstruction for revision lumbar surgery in Bulgaria

Abstract

In the last decade, spinal surgery has undergone an extremely rapid development, and it is no coincidence that Prof. Benzel - one of the founders of modern spinal surgery called it the "Decade of the spine". The introduction of endoscopic surgery, navigation systems, intraoperative 3D imaging, and robotic surgery have fundamentally changed the concept of spine surgery. These technologies provide the possibility of a complex completely minimally invasive surgery, which was unthinkable until 10 years ago, or the achievement of the goal of surgery was associated with a long recovery and many postoperative complications.

We present a clinical case of a patient with multiple (more than 10) operative interventions on the lumbar segment of the spine, with post-operative complications such as infections, spinal instrumentation malfunction, neurological deficits, which led to severe disability and greatly reduced quality of life. Upon completion of the diagnostic process, severe deformiting spondyloarthrosis, impaired sagittal and coronal balance of the lumbar spine, combined with severe three-level instability were found. Preoperative surgical planning includes correction of sagittal and coronal balance, stabilization of unstable segments.