Tamara Aepli

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Tamara Aepli

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Degenerative Spine

My most recent project with the AO Surgery Reference took me to New York and Verona, where I collaborated with the AO Foundation team and experts in minimally invasive spine surgery to create a module addressing degenerative spine.

Here, you'll find a curated selection of illustrations from the comprehensive module, with the entire collection available for access online on AO Surgery Reference.

See published module
screenshot of AO Surgery Reference app

Diagnosis

This illustration displays six different types of disc pathologies.

views of spinal discs showing bulge, protrusion, contained extrusion, uncontained extrusion, sequestration and pseudoherniation

Microscopic

The following two illustrations show excerpts from descriptions of microscopic techniques.

microscopic cervical spine surgery. Extruded fragments are removed with pituitary rongeurs
microscopic tubular unilateral laminotomy surgical step of decompression

Endoscopic

The following two illustrations show excerpts from descriptions of endoscopic techniques.

surgical step of bone reaming on superior articular process resection
endoscopic surgical step view of thecal sac and traversing nerve root

Safe zone and pitfalls

These illustrations highlight safe zones for surgical maneuvers: enucleation in the first image and bone reaming close to the spinal dura in the second.

oblique view of two lumbar vertebras with spinal cord, highlighting the safe channel
pitfall: start drilling at the inferior edge of the lamina and not the middle

Surgical instruments

This image features all necessary surgical instruments for a specific procedure.

surgical instruments for degenerative spine surgery

Verification clock

Verification of lumbar spinal stenosis decompression is systematically performed in a clockwise manner. The clock visualization in this image aids in controlling all the steps of the decompression procedure.

clock used as verification aid for decompression

Minimally invasive transpsoas approach

This example illustrates the approach used for the Lateral Lumbar Interbody Fusion (LLIF) procedure, showing the detachment of the psoas muscle from the peritoneum with the finger.

Access the approach description here:

See published description
lateral lumbar interbody fusion approach step

Patient preparation and OR Setup

patient positioned laterally on an operating table
operating room setup