XLIF® Case Review

Zullo Nicola M.D.

Male, 83 years

3 year low back pain

Failed conservative therapy

Physical exam positive for radiculopathy (claudicatio 100 m)

Severe stenosys on MRI and spondilolistesys L3L4 and L4-L5

No pain using bicycle

Inability to stand supine position

[Case #1, Pre-op]

[Case #1]

[Case #1]

L2-L3

L3-L4

[Case #1]

Left Foraminal view Right Foraminal view

[Case #1]

L3-L4

L2-L3

L4-L5

NRS Back 7

NRS Leg 7

ODI 47

Pre - operative

3 Days post - operative

3 Months post - operative

NRS Back 2

NRS Leg 4

ODI 9

3 Months post - operative

6 Months post - operative

6 Months post - operative

NRS Back 2

NRS Leg 2

ODI 6

Female, 84 years

4 year low back pain

Failed conservative therapy

Physical exam positive for radiculopathy (claudicatio 300 m)

Severe stenosys on MRI at L4-L5

2009 Vertebroplasty L1

Pre - operative

NRS Back 9

NRS Leg 6

ODI 51

[Case #3, Pre-op]

Intra- operative

Intra- operative

3 Days post - operative

3 Months post - operative

NRS Back 5

NRS Leg 5

ODI 16

3 Months post - operative

6 Months post - operative

NRS Back 5

NRS Leg 5

ODI 38

6 Months post - operative

Female, 76 years

5 year low back pain

Failed conservative therapy

Physical exam positive for radiculopathy (claudicatio 100 m)

Stenosys on MRI and spondilolistesys L4-L5

Diabetes

Osteoporosis

Pre - operative

NRS Back 7

NRS Leg 8

ODI 49

PI 53°

PT 19°

LL 71°

3 Days post - operative

3 Months post-operative

3 Months post-operative

NRS Back 3

NRS Leg 3

ODI 12

Male, 43

10 year low back pain with some radicular left leg pain

Failed conservative therapy

Physical exam negative for radiculopathy

No root compression on MRI

No comorbidities

Pre - operative

NRS Back 8

NRS Leg 4

ODI 34

3 Days post - operative

1 month post-op

3 months post-op

3 Months post - operative

NRS Back 1

NRS Leg 1

ODI 18

• Male 42 YO, obesity, building industry worker

• two years low back pain with right mild L5 raduclopaty

• Failed conservative therapy• L4-L5 Degenerative disc disease

Modic 2 Pfirrmann IV with associated spinal canal narrowing

• No clear nerve root compression on MRI

• Physical exam: mild right radiculopaty, sever low back pain

• No significant co-morbidities

Pre-operative assessment

NRS back 8

NRS Leg 2

ODI 32/50

Pre-operative imaging

Pre-operative imaging

L4-L5 L5-S1

SPINO-PELVIC ASSESSMENT

PT 40°

PI 20°

LL 12°

C7 PL midpoint S1 plate

1 month post-op X-ray

Three months CT scan

Three month post-op. assessment

NRS Back 1

NRS Leg 0

ODI 0/50