Revision of a lumbar disc arthroplasty following late infection

[摘要] OpenimageinnewwindowAnteriorremovalofalumbartotaldiscreplacementimplantisoftenaverytechnicallydemandingprocedure.Theanteriorretroperitonealanatomyispronetoscarring,limitingremobilizationandmakingadirectanteriorexposureabovetheL5–S1leveldifficultifnotimpossibletoachievesafely.AnterolateralapproachstrategiescanbemoresafelyachievedatL4–L5andabove,butmayrequirevertebralosteotomyinordertoremoveakeeledprosthesis.Successfulconversiontoafusionwithimplantremovalcanbeachieved,evenwhenosteotomyisneededforimplantremoval.ThisGrandRoundscasepresentationinvolvesanunusuallateretroperitonealabscessfollowingtwo-levelTDRwithdirectextensiontooneoftheimplants,andthesubsequentnonoperativeandoperativemanagement.Removalofawell-fixedkeeledimplantattheL4–L5levelfollowingnonoperativetreatmentofasurroundingretroperitonealabscessandconversiontofusionrepresentscloseto,ifnota‘worst-case’scenarioforrevisionTDR.However,withproperpreoperativeplanningandsurgicalexperience,asafeandsuccessfulprocedurecanbetheendresult...

[学科分类] 骨科学

[关键词] Lumbar disc arthroplasty ;Anterior lumbar revision surgery ;Prodisc-L ;Late Infection