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1. Trevor Goodchild:verified::pondering_orb: (trevorgoodchild@poa.st)'s status on Tuesday, 10-Dec-2024 23:10:49 JST Trevor Goodchild:verified::pondering_orb:

   in reply to

   • Tiberius J. Nougat
   • Mrs. Emma Rooks
   @lord_nougat @emma_rooks I'm just an internet rando with an Æon Flux avatar, no one should listen to me, I'm also insane :iminsane:
   • Kenny Blankenship likes this.
   • Mrs. Emma Rooks (emma_rooks@nicecrew.digital)'s status on Tuesday, 10-Dec-2024 23:10:50 JST Mrs. Emma Rooks

     in reply to

     • AmonMaritza
     Right, all we can do is speculate. I'd guess the spondylolisthesis was significant enough that they wanted to stabilize it and prevent further slippage, which could have resulted in neural impingement or weakness or even paralysis.
   • Trevor Goodchild:verified::pondering_orb: (trevorgoodchild@poa.st)'s status on Tuesday, 10-Dec-2024 23:10:50 JST Trevor Goodchild:verified::pondering_orb:

     in reply to

     • Mrs. Emma Rooks
     @emma_rooks The only acceptable answer is that he had acute instability on flexion-extension dynamic lumbar X-rays, or progressive neurological dysfunction. And I doubt either was the case.
     
     There are tons of young men and women with bilateral pars defects and a stable spondy. They can be managed nonoperatively for decades.
   • Tiberius J. Nougat (lord_nougat@nicecrew.digital)'s status on Tuesday, 10-Dec-2024 23:10:50 JST Tiberius J. Nougat

     in reply to

     • Mrs. Emma Rooks

     I hereby promote you to DOCTOR Goodchild!

   • Mrs. Emma Rooks (emma_rooks@nicecrew.digital)'s status on Tuesday, 10-Dec-2024 23:10:51 JST Mrs. Emma Rooks

     in reply to

     • AmonMaritza
     The film is taken at a bit of an angle. Those screws are probably close to parallel on an AP view, but given how much you can see of the endplates (tops and bottoms of the vertebral bodies), It looks really off. It looks like there was some crazy anterolisthesis (anterior slippage of L5 on S1) and they tried to make it as stable as possible. I have no idea what happened to cause such an injury. Are we sure these films belong to the guy?
   • Trevor Goodchild:verified::pondering_orb: (trevorgoodchild@poa.st)'s status on Tuesday, 10-Dec-2024 23:10:51 JST Trevor Goodchild:verified::pondering_orb:

     in reply to

     • AmonMaritza
     • Mrs. Emma Rooks
     @emma_rooks @AmonMaritza 1. No, we have no assurance those are his films
     2. You are absolutely correct, this is not a true lateral view. The endplates are off. We also have no AP or pre-op images to compare
     3. He has a grade I L5-S1 spondylolisthesis on this view, possible pars defects at this level. No idea what he looked like before surgery
     
     That being said:
     
     >absent acute spinal trauma, why was a 20-something year old fused in the first place?!
     >top L5 screw is riding the endplate, suboptimal
     >S1 screws are far too long, rookie mistake, you try to subtract 5mm at that level
     >they did not appear to place an interbody graft, not ideal in a young patient
     >WHY WAS HE FUSED IN THE FIRST PLACE (most important question)
   • Trevor Goodchild:verified::pondering_orb: (trevorgoodchild@poa.st)'s status on Tuesday, 10-Dec-2024 23:10:52 JST Trevor Goodchild:verified::pondering_orb:

     in reply to

     • Mrs. Emma Rooks
     @emma_rooks Damn baby keep talking like that and who knows what will habben
     
     (You're right, but that's only one of the issues)
   • AmonMaritza (amonmaritza@nicecrew.digital)'s status on Tuesday, 10-Dec-2024 23:10:52 JST AmonMaritza

     in reply to

     • Mrs. Emma Rooks
     The top screw doesn’t look well positioned.
   • Mrs. Emma Rooks (emma_rooks@nicecrew.digital)'s status on Tuesday, 10-Dec-2024 23:10:53 JST Mrs. Emma Rooks

     in reply to
     That doesn't look right. It's an L5-S1 posterior lumbar interbody fusion with instrumentation, but those are some long pedicle screws. 🤨
   • Trevor Goodchild:verified::pondering_orb: (trevorgoodchild@poa.st)'s status on Tuesday, 10-Dec-2024 23:10:54 JST Trevor Goodchild:verified::pondering_orb:
     This is such a fucking hackjob L5-S1 spine fusion, the longer I stare at it the angrier I get :2brage: