Complex Revision Spine Surgery | Septic Spine Surgery

Dr Basil Al Sharef
4 days ago
1 min read

Septic spine surgery after multiple failed operations is always challenging and requires experience, careful planning, and the right strategy.

This case highlights the importance of selecting the correct indication and procedure from the very first surgery.

The patient initially had L4 spondylolysis (pars defect) and underwent pars repair at the age of 23 in Doha, which unfortunately failed. In 2022, he underwent revision surgery in London, UK, using what was described as the “smiley-face technique.” This procedure also failed and was complicated by postoperative infection and increased instability due to destruction of important bony structures responsible for spinal stability. Later that same year, a further revision was performed in Doha to remove the smiley-face instrumentation.

I treated the patient after these multiple surgeries with radical debridement and a combined anterolateral-posterior approach, performing an L4/5 interbody fusion using the XLIF technique.

The current CT scan demonstrates solid interbody and posterior fusion, with restoration of stability and a good clinical outcome.

This case emphasizes that proper indication and surgical planning at the initial stage are critical for achieving long-term success.