A 52-year-old male presented with progressively worsening chronic back pain, including intermittent pain. MRI was contraindicated due to the presence of metal fragments; therefore, a CT scan was performed, revealing severe L4–L5 disc space narrowing, endplate degeneration, and no mobility on flexion-extension films.
The patient underwent percutaneous L4–L5 interbody fusion with a 9×23 mm expandable Zavation cage and 3 cc of DBM. To prepare the disc space, 6–10 mm MaxMoreSpine side-cutting drills were employed alongside the new split Morgenstern MaxFusion-Dilator. Bilateral 10×6 mm facet screws (instead of pedicle screws) provided additional fixation. The entire procedure was done in an outpatient ambulatory setting, taking approximately 90 minutes including facet screw placement, with stable neuromonitoring.
Postoperative imaging confirmed a markedly opened L4–L5 disc space and central placement of the interbody cage. The patient’s original back pain has resolved with no leg pain, reporting only incisional discomfort. The surgery was performed at Miami Neurosurgical Associates, ASC Miami Regional Surgical Center (Surgipoint). Facet screws were supplied by Surgentec, and the expandable cage was from Zavation.
With MaxFusion, you can place a (P)TLIF in a less invasive, safe, and fast way. Patients experience less postoperative pain and can return to normal activities sooner.
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