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Case Reports
. 2018 Jul 11:2018:9142074.
doi: 10.1155/2018/9142074. eCollection 2018.

Malposition of Cage in Minimally Invasive Oblique Lumbar Interbody Fusion

Chaiwat Kraiwattanapong  1 , Vanlapa Arnuntasupakul  2 , Rungthiwa Kantawan  3 , Gun Keorochana  1 , Thamrong Lertudomphonwanit  1 , Pakkanut Sirijaturaporn  1 , Methawut Thonginta  1
Affiliations
Case Reports

Malposition of Cage in Minimally Invasive Oblique Lumbar Interbody Fusion

Chaiwat Kraiwattanapong et al. Case Rep Orthop. .

Abstract

Introduction: Minimally invasive oblique lumbar interbody fusion is one of the novel lateral lumbar interbody fusion techniques for which the successful early results have been reported. However, new complications were increasingly reported from ongoing studies.

Case presentation: We report a case of an unusual complication of minimally invasive oblique lumbar interbody fusion associated with contralateral nerve root compression due to deep and posterior position of polyetheretherketone cage and discussion of the operating technique for repositioning polyetheretherketone cage.

Conclusion: Malposition of polyetheretherketone cage can cause contralateral nerve root compression and neurological complication. The surgical technique to proper pull the polyetheretherketone cage back into the acceptable position should be considered and well prepared.

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Figures

Figure 1
Figure 1
Preoperative MRI of lumbosacral spine T1W image showed prepsoas corridor at the level of intervertebral disc space L4-L5 (a and b) and at the level of upper vertebral body of L5 (c and d). Rising of psoas muscle was shown in (d). Left common iliac artery almost obliterates prepsoas space at level of upper vertebral body of L5 (black asterisk).
Figure 2
Figure 2
Postoperative plain films of lumbar spine AP and lateral (a and b) showed the MIS-OLIF PEEK cage was placed too deep over edge of right lateral of vertebral body.
Figure 3
Figure 3
Model picture showed the possibility that MIS-OLIF PEEK cage locked with the vertebral endplates.
Figure 4
Figure 4
Drawing picture showed the reverse jack-knife position of the patient with distraction of retractor blade pins for loosening the MIS-OLIF PEEK cage form the vertebral endplates.
Figure 5
Figure 5
Three months postoperative plain films of lumbar spine AP and lateral (a and b) showed the acceptable position of MIS-OLIF PEEK cage.
See this image and copyright information in PMC

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