Antécédents du patient

The patient complained of severe lumbar pain irradiant vers la jambe droite jusqu'au pied et vers la fesse gauche. Debout, le corps était incliné à droite en raison de la scoliose. Un désalignement pelvien a été noté.

Independent mobility and maintaining a standing position were impossible. Le patient n'avait aucune force ni sensation dans la jambe droite jusqu'au pied. La sensibilité sur la face externe de la cuisse gauche était également absente. A condition bordering on disability, for which classical orthopedics recommends multi-level stabilization surgery.

Diagnostic

Right-sided scoliosis — lumbar spine deformity with body tilt
Ventral spondylolisthesis L4 — L4 displacement relative to L5 by 6 mm
Central-lateral herniation L5/S1 — 14 mm — large herniation with nerve structure compression
Protrusion and spinal canal stenosis L4/L5 — caused by spondylolisthesis
Bilateral neuroforaminal stenosis — bilateral root compression
Right lower extremity paraparesis — neurological deficit with loss of strength and sensation

Rapport opératoire — Méthode MIBRAR®

Microinvasive procedure performed at the MIBRAR clinic (Munich) under Prof. Dr. med. Arsen Babayan. Outpatient, under local anesthesia.

Spinal canal catheterization using a rigid epidural catheter
Transforaminal peridural catheterization on the right at L4/L5, L5/S1 levels — root decompression
Peridural catheterization L3/L4 bilaterally — canal widening
Intra-articular catheterization at L3/L4, L4/L5, L5/S1 levels bilaterally — facet joint treatment
Right-sided intradiscal catheterization L4/L5, L5/S1 with CGF concentrate — disc regeneration stimulation
Anterior and posterior longitudinal ligament catheterization at L4/L5 level — spinal segment stabilization

MRI Scans Before and 1 Year After MIBRAR®

Gauche — IRM une semaine avant l'intervention. Droite — contrôle un an après MIBRAR®. Régénération discale, résolution de la scoliose et restauration anatomique de la position vertébrale sont visualisées.

Lumbar MRI: scoliosis, spondylolisthesis L4, L5/S1 herniation 14 mm — before and 1 year after MIBRAR®

Sagittal MRI (first plane): Left — right-sided scoliosis, L4 ventral displacement, L5/S1 herniation, canal stenosis. Right — after 1 year: disc regeneration, compression resolution, sagittal balance restoration.

Lumbar MRI: second sagittal slice — L4/L5, L5/S1 stenosis before and after MIBRAR®

Sagittal MRI (second plane): Left — L4/L5 canal stenosis, neuroforaminal stenosis, disc degeneration. Right — canals free, disc height restored, nerve structures decompressed.