In a sea of LinkedIn content, here's genuine surgical discourse. Complex revision cases, like the one Dr. med. Samir Smajic details here, present the very challenges that keep us awake at night - and drive us forward. How do we restore disc height whilst minimising trauma? What's the optimal approach for achieving lordosis in revision scenarios? These aren't simple questions, yet they're precisely the ones we must grapple with. Particularly fascinating was the exchange between Dr. med. Samir Smajic and Alin Sirbu about OLIF versus XALIF approaches. It's this kind of candid discussion about technique preferences and learning curves that truly advances our field. And @Vinay Kulkarni's probing question about posterior rods demonstrates exactly the kind of detailed technical discourse we need more of on LinkedIn. "Go in small, then correct" isn't just our philosophy - it's born from listening to exactly these sorts of conversations amongst surgeons tackling real-world challenges. Whilst it's easy to default to self-promotion on LinkedIn, posts like this - rich in technical detail and sparking genuine professional dialogue - remind us why we're all here: to advance spinal surgery and improve patient outcomes. Bravo, Dr. Smajic, for fostering such meaningful discourse. More of this, please! #SpinalSurgery #SurgicalInnovation #ProfessionalDevelopment #ContinuousLearning
Chefarzt I Wirbels?ulenchirurg I Pr?sident der Bosnisch-Herzegowinischen ?rztegesellschaft in Deutschland
Strategy for Failed Back Surgery In light of yesterday's case presentation involving pseudarthrosis at L5/S1 and facet joint destruction at L4/5 due to the intraarticular placement of the L5 screw, an effective surgical strategy is essential. First, the extraction of the posterior set screw at L5 should be done. Following this, an ALIF L5/S1 helps to restore disc hight and segmental lordosis. In such cases, the XALIF technique performed in lateral decubitus position proves advantageous, allowing for simultaneous access to both posterior and anterior structures. In this particular case, the optimal fusion technique is most probably an OLIF at L4/5, particularly due to the anatomical challenge presented by a high iliac crest or higher perioperative risks for ALIF L4/5. A dorsal prone screw revision is also necessary, which should include repositioning and re-establishing lordosis to optimize spinal alignment. This comprehensive strategy aims to address the complexities associated with failed back surgery, enhancing patient outcomes through a multi-faceted surgical approach.