Traumatic Vertebral Fracture

Bolt Provided Safe and Accurate Navigation When Trauma Presented the Need for Precise Screw Placement

Patient Overview

Age

60 years old

Sex

Male

Diagnosis:

T12 fracture

Surgery Details

Procedure

T11-L1 stabilization to restore neurologic function and offer the opportunity to return to daily activities.

Levels with fixation:

T11-L1

Fixation Type

Pedicle screw fixation

Patient Background and Diagnosis

This patient was a 60-year-old male who was working on an oil rig when a 400-pound cylindrical pipe fell and struck him on the back. He was immediately transported to the hospital via helicopter. Upon assessment, the patient presented with a T12 fracture and associated neurological deficit. The fracture involved the vertebral body, facets, and pars interarticularis.

mri of damaged t12. — Sagittal MRI image of T12 displaying vertebral fracture to the body, pars and facets.

Surgical Treatment

The patient underwent a T11-L1 stabilization to restore neurologic function and offer the opportunity to return to daily activities. The placement of the screws at T12 needed to achieve specific diverging medial and sagittal trajectories to avoid the fractured elements. The pedicle screw placement was planned and executed utilizing the Bolt Navigation System.

fluoro image of a spine. — A/P Fluoro Image showing final pedicle screw placement. Note caudal and diverging screw placement at T12 to navigate fx fragments.

guiding an operation using bolt nav equipment. — Guiding the pedicle probe down the corridor of the planned trajectory using the Bolt Navigation System.

Experience

The Bolt Navigation System allowed the surgeon the ability to precisely place the screws in an emergency setting, utilizing a standard C-arm and the patient’s diagnostic imaging. The system enabled the planning and accurate placement of the screws, in an atypical trajectory, with the staff and available equipment. The Bolt Navigation System provided a practical, easy to use, accurate, and low-radiation alternative to legacy navigation systems for this challenging case.