Minimally Invasive Corpectomy in Metastatic Thoracolumbar Spine Disease:The Posterolateral Transpedicular Approach

2016 ◽  
Vol 0 (4) ◽  
Author(s):  
Eleftherios Archavlis ◽  
Nikos Papadopoulos ◽  
Peter Ulrich
Keyword(s):  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Transpedicular Approach

Use of the SpineJack direct reduction for treating type A2, A3 and A4 fractures of the thoracolumbar spine: a retrospective case series

2021 ◽  
pp. neurintsurg-2021-017682
Author(s):  
Giorgio Lofrese ◽  
Luca Ricciardi ◽  
Pasquale De Bonis ◽  
Francesco Cultrera ◽  
Michele Cappuccio ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Direct Reduction ◽  
Thoracolumbar Spine ◽  
Case Series ◽  
Osteoporotic Fractures ◽  
Neurological Impairment ◽  
Radiological Outcome ◽  
Retrospective Case ◽  
Younger Patients ◽  
Kyphosis Correction

BackgroundCompression injuries of the thoracolumbar spine without neurological impairment are usually treated with minimally invasive procedures. Intravertebral expandable implants represent an alternative strategy in fractures with low fragments’ displacement.MethodsPatients with A2, A3 and A4 fractures of the T10–L2 spinal segment without neurological impairment, fracture gap >2 mm, vertebra plana, pedicle rupture, pedicle diameter <6 mm, spinal canal encroachment ≥50%, and vertebral body spread >30% were treated with the SpineJack device. Patients with pathological/osteoporotic fractures were excluded. Demographic and fracture-related data were assessed together with vertebral kyphosis correction, vertebral height restoration/loss of correction and final kyphosis. The modified Rankin Scale (mRS), Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), Smiley–Webster Pain Scale (SWPS) and EuroQol-5D (EQ-5D) were evaluated at 1 (-post), 6 and 12 months (-fup) after surgery. Statistical analysis was performed and p values ≤0.05 were considered significant.ResultsFifty-seven patients were included in the study. Patients aged >60 years reported worse kyphosis correction (<4°) with more postoperative complications, while vertebral plasticity in younger patients, fragmentation-related greater remodeling in A3/A4 fractures, and treatments within 7 days of trauma determined superior wedging corrections, with better EQ-5D-post and mRS-fup. Cement leakages did not affect functional outcome, while female gender and American Society of Anesthesiologists (ASA) score of 3–4 were associated with worse ODI-fup and VAS-fup. Although fracture characteristics and radiological outcome did not negatively influence the clinical outcome, A2 fracture was a risk factor for complications, thus indirectly compromising both the functional and radiological outcome.ConclusionWith spread of <30%, the SpineJack is an alternative to minimally invasive fixations for treating A3/A4 thoracolumbar fractures, being able to preserve healthy motion segments in younger patients and provide an ultra-conservative procedure for elderly and fragile patients.

scholarly journals Posterior Minimally Invasive Transpedicular Approach for Giant Calcified Thoracic Disc Herniation

2020 ◽  
pp. 219256822093327 ◽  
Author(s):  
Daniel Shedid ◽  
Zhi Wang ◽  
Ahmad Najjar ◽  
Sung-Joo Yuh ◽  
Ghassan Boubez ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Disc Herniation ◽  
Case Series ◽  
Thoracic Disc Herniation ◽  
Retrospective Case ◽  
Tubular Retractor ◽  
Posterior Surgery ◽  
Transpedicular Approach ◽  
Dural Tears ◽  
Thoracic Disc

Study Design: Retrospective case series. Objective: Posterior surgery for thoracic disc herniation was associated with increased morbidity and mortality and new minimally invasive approaches have been recommended for soft disc herniation but not for calcified central disc. The objective of this study is to describe a posterolateral microscopic transpedicular approach for central thoracic disc herniation. Methods: This is a single center retrospective review of all the cases of giant thoracic calcified disc herniation as defined by Hott et al. Presence of myelopathy, percentage of canal compromise, T2 hypersignal, ASIA score, and ambulatory status were recorded. This posterolateral technique using a tubular retractor was thoroughly described. Results: Eight patients were operated upon with a mean follow-up of 16 months. Mean canal compromise was 61%. Mean operative time was 228 minutes and mean operative bleeding was 250 mL. There were no cases of dural tear or neurologic degradation. Conclusion: This is the first report of posterior minimally invasive transpedicular approach for giant calcified disc herniation. There were neither cases of neurological deterioration nor increased rate of dural tears. This technique is thus safe and could be recommended for treatment of this rare disease.

scholarly journals Thoracoscopic spine surgery for decompression and stabilization of the anterolateral thoracolumbar spine

2005 ◽  
Vol 19 (6) ◽  
pp. 1-9 ◽  
Author(s):  
Amin Amini ◽  
Rudolf Beisse ◽  
Meic H. Schmidt
Keyword(s):  
Minimally Invasive ◽  
Spine Surgery ◽  
Thoracoscopic Surgery ◽  
Thoracolumbar Spine ◽  
Spinal Column ◽  
Open Thoracotomy ◽  
Thoracoscopic Approach ◽  
Respiratory Problems ◽  
Gain Access ◽  
Video Assisted Thoracoscopic Surgery

The anterior thoracolumbar spine can be exposed via a variety of approaches. Historically, open anterolateral or pos-terolateral approaches have been used to gain access to the anterior thoracolumbar spinal column. Although the exposure is excellent, open approaches are associated with significant pain and respiratory problems, substantial blood loss, poor cosmesis, and prolonged hospitalization. With the increasing use of the endoscope in surgical procedures and recent advances in video-assisted thoracoscopic surgery, minimally invasive thoracoscopic spine surgery has been developed to decrease the morbidity associated with open thoracotomy. The purpose of this article is to illustrate the surgical technique of a minimally invasive thoracoscopic approach to the anterolateral thoracolumbar spine and to discuss its potential indications and contraindications in patients with diseases involving the anterior thoracic and lumbar regions.

Results of surgical treatment of aggressive hemangiomas of the treatmental spine by the method of punctive vertebroplasty

2021 ◽  
Vol 19 (3) ◽  
pp. 75-80
Author(s):  
Sh. Sh. SHATURSUNOV ◽  
◽  
S. A. MIRZAKHANOV ◽  
A. R. SATTAROV ◽  
A. O. KOBILOV ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Pain Syndrome ◽  
Average Score ◽  
Treatment Results ◽  
Antitumor Effects ◽  
X Ray ◽  
Mri Studies ◽  
Invasive Method

The purpose — to analyze the results of surgical treatment of patients with hemangiomas of the thoracolumbar spine by puncture vertebroplasty. Material and methods. Clinical data and results of surgical treatment of 124 patients operated on in 2014-2020 were analyzed. Preoperative examinations included clinical studies, WAS, Oswestry, X-ray, MSCT, and MRI. MSCT and MRI studies were carried out for diagnosis and to study the treatment results. Single hemangiomas were present in 63 (50,8%) patients, 44 (35,4%) patients had hemangiomas at two or more levels. In 17 (13,7%) patients, hemangiomas were present in both the thoracic and lumbar regions. Results. In 87,8% of cases, MSCT studies in the postoperative period showed filling the hemangioma cavity by more than 80%. Control MRI studies 6 months and a year after surgery in none of the cases revealed a continued growth of hemangioma. Pain syndrome according to WAS before surgery averaged 46/56 points, after 12 months — 15/20 points. According to the Oswestry questionnaire, the average score reduced from 32 to 6 points after 6 months. Conclusion. Puncture vertebroplasty with bone cement is an effective, safe and minimally invasive method for treating hemangiomas of the thoracolumbar spine. The main goals of vertebroplasty are to restore the supporting ability of the affected vertebra, achieve analgesic and antitumor effects.

P88. Minimally Invasive Instrumentation and Fusion of Thoracolumbar Spine Fractures

2009 ◽  
Vol 9 (10) ◽  
pp. 159S-160S
Author(s):  
Bob Greenleaf ◽  
Daniel Altman ◽  
J. Brad Bellotte ◽  
Bradley Palmer ◽  
Lauren O'Keefe
Keyword(s):  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Spine Fractures ◽  
Thoracolumbar Spine Fractures
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