Pre-operative planning is of vital importance in developing a custom-made surgical solution. Prof. Mayer shared another case he encountered in 2013. The patient was a 75-year-old female who had undergone fusion surgery on L2-5 for degenerative lumbar scoliosis in another hospital. She had progressive back pain and lumbar radiculopathy at right side of L3. And multiple injections treatments, like facets injection and lumbar epidural steroid injections, were no use to ease her pain.
The original plan was first to remove the original implants, to do a posterior release, then to do MINI-ALIF of L5-S1 and OLIF with correction of L1-2-3-4-5 , and then to implant a posterior instrumentation. However, when doing the OLIF approach, he encountered an accident that resulted in an injury of abdominal aorta at L3-4 of the patient. Then a vascular surgeon was called in to handle the situation. A week later, Prof. Mayer proceeded the surgical solution. He did a posterior instrumentation and TLIF on L1-2-3-4 for the patient. 5 years after the surgery, the patient was satisfied with the result, except for occasional sacroiliac joint pain. In the end of the case, Prof. Mayer shared his detailed analysis of the cause of aorta injury and discussed how to avoid this kind of accident in the future.