Showing Case Studies for: Fixed Sagittal Imbalance

S1 Failure in an Elderly Female

Presented by: C. Shaffrey MD

This elderly female previously underwent a T10-S1 fusion at another institution and presents with postural change and increased back pain.

Debilitating Back Pain with Neurogenic Claudication

Presented by: N. Anand MD

This 76-year-old female presented with debilitating back pain, sagittal imbalance, and neurogenic claudication.

Kyphosis Deformity Correction in Ankylosing Spondylitis

Presented by: J. Cuéllar MD, PhD, T. Lanman MD, FAANS, FACS
In this case of kyphosis deformity correction in ankylosing spondylitis with compression fractures, how much correction is optimal?

Lumbar Sagittal Balance Restoration: Less Invasive?

Presented by: J. Ammerman MD, J. Wind MD, J. Babrowicz MD
A 68-year-old female presents with standing intolerance, neurogenic claudication and back pain. Her past medical history includes coronary artery disease, diabetes, hypertension, hypothyroidism, and atrial fibrillation.

Severe Sagittal Imbalance Correction

Presented by: A. Daniels MD, D. Reid MD, M. Palumbo MD
A 76-year-old male presented with severe positive sagittal imbalance and neurogenic claudication following a prior L3-S1 decompression and fusion performed by a community neurosurgeon.

Severe Sagittal Imbalance and Lumbar Spinal Stenosis in a Patient with Multiple Medical Comorbidities

Presented by: A. Jorgensen MD, H. An MD
The patient is a 50-year-old male with end-stage renal disease (ESRD), on dialysis, and presents with a 10-year history of low back pain. He was a successful engineer. However, he had to go on disability starting two years ago due to progression of his symptoms.

Woman with Ankylosing Spondylitis

Deformity Makes It Difficult to Look People in the Eye
Presented by: .

The patient is a 66-year-old female with ankylosing spondylitis who independently ambulates without any aids.  Her deformity makes horizonal gaze difficult.  How would you approach treatment, and what risks are involved?

Sagittal Imbalance following Previous Surgery

Presented by: F. Schwab MD
This case illustrates the complex nature of sagittal spinal imbalance including a shift in her center sacral line secondary to multi-level degenerative lumbar discs.

Growing Spine Case: 5-Year-old with Increasing Spinal Deformity

Presented by: C. Johnston MD
A 5-year-old male, with an uncharacterized congenital myopathy, presented for increasing spinal deformity.

Post-traumatic Kyphosis 5 Years After Motorbike Accident

Intense Pain and Progressive Deformity
Presented by: W. Carrero MD
Five years prior to presenting, the patient was involved in a motorcycle accident, resulting in a dorsal vertebral fracture. Since then, he reports intense pain and progressive thoracic deformity.

Kyphoscoliosis in a 71-year-old Female

Should You Fuse to the Sacrum or Pelvis?
Presented by: S. Glassman MD
How would you treat this patient? She is 71 years old and presents with progressive loss of standing balance, severe back pain and buttock pain, and moderate neurogenic claudication.

Retired Truck Driver with Progressive Axial Low Back Pain

Presents with Radiculopathy, and Cauda Equina Syndrome
Presented by: M. Dekutoski MD
The patient is a 66-year-old male retired security truck driver. He underwent an L3-S1 in situ fusion for leg pain and spondylolisthesis 30 years prior to presenting in our office. He now has a primary complaint of pain that worsens with activity and at the end of the day.

Ankylosing Spondylitis with Thoracic Fracture

Do You Fix Both the Fracture and the Deformity?
Presented by: D. Polly, Jr. MD
The patient is a 70-year-old male with chronic back pain and worsening trouble standing up. He has known long-standing ankylosing spondylitis, and he was referred to a spine surgeon after a non-union at a thoracic fracture site was seen. Do you fix the fracture alone, or fix the deformity, too?

Leg Pain and Sagittal Imbalance

Presented by: K. Bridwell MD
The patient has subluxations at L3-L4, fixed tilt at L4-L5, and disc degeneration at all lumbar levels. Spinal stenosis is noted at many lumbar levels.

Flatback following Non-instrumented Adolescent Idiopathic Scoliosis Surgery

Presented by: F. Schwab MD
This case of a middle-aged female, who underwent non-instrumented fusion to treat scoliosis, illustrates classic flatback syndrome.
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