Neither the device nor films of applicable imaging studies were returned to the manufacturer for evaluation.Therefore, we are unable to determine the definitive cause of the reported event.If information is provided in the future, a supplemental report will be issued.
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The patient was pre-operatively diagnosed with l4-l5 pseudoarthrosis with retained hardware, degenerative disc disease, segmental lumbar instability and spinal stenosis and underwent the following procedures: l4-l5 fusion exploration.L4-5 removal posterior segmental instrumentation.L4 revision laminectomy with decompression of cauda equina and spinal nerve roots.L5 laminectomy with decompression of cauda equina and spinal nerve roots.L4-l5 revision posterior spinal fusion.L4-l5 segmental instrumentation with pedicle screws.Use of local bone graft, cancellous allograft, and bmp.Insertion of indwelling opioid catheter for postop analgesia.Use of operating microscope.L4-l5 anterior lumbar diskectomy and interbody fusion.L4-l5 anterior lumbar machine allograft.L4-5 anterior segmental instrumentation.As per op-notes,¿ the level was confirmed using a lateral image with the spinal needle in place.The l4- l5 annulotomies carried out and a complete diskectomy and decompression from the anterior aspect of the disk space was performed.The peek interbody device was removed without difficulty.The patient had bmp used in the last surgery and there was some inadvertent extravasation of the disk space and this ectopic bone was removed through the anterior approach.The end plates were prepared as we proceed.A 13mm corticocancellous allograft was selected and a small central canal created.A half strip of bmp/acs was used to fill the space.A 41 mm lumbar plate from the synthes integra set was used and the lateral c-arm image reveals the appropriate length and it was then secured to the l4 and l5 bodies with four 6.5 x 20-mm corticocancellous locking screws.¿ the patient tolerated the procedure well without any intraoperative complications.
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