Procedure Changed from XLIF to TLIF Due to Low Threshold
By Admin | July 03, 2024
Chronic lower back pain can be a daunting challenge, impacting every aspect of a person’s life. Imagine facing this relentless pain while grappling with the weight of multiple spinal conditions. Not only do the physical implications of this kind of situation overwhelm a person but the mental implications do as well. This is the reality for many patients.
One such patient was a 54-year-old male. He presented with a myriad of spinal issues, from radiculopathy to spondylosis and degenerative disc disease. This patient reported symptoms of low back and bilateral leg pain and his medical history included a previous cancer diagnosis, hypertension, smoking, and hypercholesterolemia.
In cases like the one outlined above, surgical intervention becomes necessary to alleviate symptoms and restore quality of life. The surgical plan for this 54-year-old involved a sequence of interventions: eXtreme Lateral Interbody Fusion (XLIF), followed by Posterior Lumbar Fusion (PLF) for added stability, and culminating in a laminectomy to relieve neural pressure.
Enter intraoperative neuromonitoring, a vital tool in ensuring surgical precision and patient safety. By employing a range of monitoring modalities, including SSEPs, TCeMEPs, EMG, t-EMG, TOF, and EEG, surgeons can obtain real-time feedback on neural activity during surgery.
During the procedure, stimulation of the dilator revealed a concerning response in the left quadriceps muscles, indicating a heightened sensitivity to nerve stimulation. Recognizing the potential risks associated with proceeding as planned, the surgical team swiftly adjusted course. Instead of XLIF, the surgeon opted for Transforaminal Lumbar Interbody Fusion (TLIF). TLIF provides better visualization, access to the nerve roots and allows decompression while avoiding the lumbar plexus.
The additional insights provided by the neuromonitoring modalities employed gave the surgical team the information they needed to adjust course mid-surgery, ensuring a successful outcome for the patient.
As we continue to explore advancements in medical technology, the role of neuromonitoring in enhancing patient care cannot be overstated. For more information on the benefits of neuromonitoring and its role in improving patient outcomes, please contact us at 888-344-2947.
