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Posterior Dynamic Stabilization as a Salvage Procedure for Lumbar Facet Degeneration Following Total Disc Arthroplasty: Case report

Paul Khoueir, MD,1 Michael Y Wang, MD2 

1Department of Neurological Surgery, Université de Montréal, Montréal, Canada 2Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, Florida

Abstract 

Following an L5–S1 SB Charité disc III implantation, a 37-year-old female patient developed intractable radicular pain in the left L5 distribution. The patient underwent a minimally invasive foraminotomy, and her symptoms improved significantly. However, following recurrence of radicular pain, she showed signs of an L5–S1 facet degeneration and recurrent nerve root compression from hypertrophied synovium. A partial facetectomy was then performed to completely decompress the L5 root with supplemental posterior dynamic stabilization using a pedicle-based flexible titanium rod system. To date, the patient remains free of symptoms. Although posterolateral fusion would have been a viable option, the application of a posterior dynamic system permitted segmental motion preservation.

keywords: 
disc arthroplasty, posterior dynamic stabilization, facet disease, revision surgery, complications, lumbar spine
Volume 1 Issue 4
doi: 
10.1016/S1935-9810(07)70060-9