Use of surgical guides in Bertolotti syndrome. Spinal arthrodesis.

Guía quirúrgica personalizada para columna sindrome bertolotti

Table of Contents

Dr. Mostaza performed his 38th surgery at the Hospital San Juan de Dios de León, using our TOR JIG® S system, personalized surgical guides for pedicle screw placement. 

Dr. Mostaza checking how the guides should be placed

Patient symptoms

The patient, who saved lumbar pain, tired legs and walking difficulties, suffered from a peculiar pathology, Bertolotti´s syndrome.

paciente con dolor en la espalda

Furthermore, he suffered from spinal canal stenosis (narrowing of the space where the spinal cord and nerve roots pass through) and scoliotic tendency. 

Bertolotti´s syndrome causes lumbarisation of the upper sacral segment. This is a fusion of the transverse process of the lumbar vertebra inferior to the sacrum, resulting in the formation of a transitional fifth lumbar vertebra. The fusion may be total or partial, unilateral or bilateral. 


Solution using surgical guides

TOR JIG S let visualize sacrum pathology in 3D and evaluate which is the best location and orientation for the screws.

Later on, this optimal placement is replicated in the operation room with the use of surgical guides. 

The use of 3D reconstructions offers the possibility to navigate and plan before entering the operating theatre. This is very useful when complex pathologies are faced and the ideal solution is not so clear just by analysing 2D CT images. 

By using Digital Anatomics´ CAD design software, the distance to the pedicle boundary in the area of S1 is double-checked. 

Pre-operative CT scan of the case of arthrodesis in Bertolotti´s syndrome
Preoperative CT scan
Postoperative CT scan of the case of arthrodesis in Bertolotti´s syndromedel caso de artrodesis en síndrome de Bertolotti
XR Control

Advantages of using TOR JIG S system

Digital Anatomics allows surgeons to 3D visualize the location of each screw in the most appropriate position on the pedicle axis. It also provides a report with all the details in order to get them either approved or modified by the surgeon prior final additive manufacturing.

For this purpose, the TOR JIG Planning tool allows the design technicians to check that everything is correct before sending the final report to the surgeon. This is due to real time views update in respect to the axis of the screws or the automatic measurement and data generation. 

Drilling process in Bertolotti´s syndrome case
Case-specific report

This system, in addition to shortening operating room times and providing greater safety for the surgeon, also offers great advantages for the patient, for example reduced exposure to X-rays.

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