scholarly journals The novel continuous bilateral Parascapular Sub-Ilicostalis Plane (PSIP) block for thoracic spine surgery

2021 ◽  
Author(s):  
Carlos Rodrigues Almeida ◽  
Lígia D. G. D. S. Vieira ◽  
Emília M. Francisco ◽  
Pedro M. F. Antunes
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
The Novel

Robotic-Assisted Endoscopic Laminotomy: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Yingda Li ◽  
Michael Y Wang
Keyword(s):  
Spine Surgery ◽  
Human Error ◽  
Robotic Assistance ◽  
The Novel ◽  
Robotic Assisted ◽  
Accuracy And Precision ◽  
Surgical Ergonomics ◽  
Patient Consent ◽  
Potential Synergy ◽  
And Robotics

Abstract Endoscopy and robotics represent two emerging technologies within the field of spine surgery, the former an ultra-MIS approach minimizing the perioperative footprint and the latter leveraging accuracy and precision. Herein, we present the novel incorporation of robotic assistance into endoscopic laminotomy, applied to a 27-yr-old female with a large caudally migrated L4-5 disc herniation. Patient consent was obtained. Robotic guidance was deployed in (1) planning of a focussed laminotomy map, pivoting on a single skin entry point; (2) percutaneous targeting of the interlaminar window; and (3) execution of precision drilling, controlled for depth. Through this case, we illustrated the potential synergy between these 2 technologies in achieving precise bony removal tailored to the patient's unique pathoanatomy while simultaneously introducing safety mechanisms against human error and improving surgical ergonomics.1,2 The physicians consented to the publication of their images.

Avoidance of Wrong-level Thoracic Spine Surgery Using Sterile Spinal Needles

2017 ◽  
Vol 30 (1) ◽  
pp. E54-E58 ◽  
Author(s):  
Kingsley R. Chin ◽  
Jason Seale ◽  
Vanessa Cumming
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine

Comparison of intraoperative neurophysiologic monitoring outcomes between cervical and thoracic spine surgery

2017 ◽  
Vol 26 (9) ◽  
pp. 2404-2409 ◽  
Author(s):  
Shujie Wang ◽  
Yuan Tian ◽  
Xiangquan Lin ◽  
Zhifu Ren ◽  
Yu Zhao ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
Neurophysiologic Monitoring ◽  
Intraoperative Neurophysiologic Monitoring

scholarly journals Microendoscopic Posterior Decompression for Treating Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum: Case Series

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 684
Author(s):  
Satoshi Baba ◽  
Ryutaro Shiboi ◽  
Jyunichi Yokosuka ◽  
Yasushi Oshima ◽  
Yuichi Takano ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
Rating Scale ◽  
Ligamentum Flavum ◽  
Case Series ◽  
Lumbar Spine Surgery ◽  
Thoracic Myelopathy ◽  
Posterior Decompression ◽  
Postoperative Hematoma ◽  
The Mean

Background and Objectives: Ossification of the ligamentum flavum (OLF) is a relatively common cause of thoracic myelopathy. Surgical treatment is recommended for patients with myelopathy. Generally, open posterior decompression, with or without fusion, is selected to treat OLF. We performed minimally invasive posterior decompression using a microendoscope and investigated the efficacy of this approach in treating limited type of thoracic OLF. Materials and Methods: Microendoscopic posterior decompression was performed for 19 patients (15 men and four women) with thoracic OLF with myelopathy aged between 35 to 81 years (mean age, 61.9 years). Neurological examination and preoperative magnetic resonance imaging (MRI) and computed tomography (CT) were used to identify the location and morphology of OLF. The surgery was performed using a midline approach or a unilateral paramedian approach depending on whether the surgeon used a combination of a tubular retractor and endoscope. The numerical rating scale (NRS) and modified Japanese Orthopedic Association (mJOA) scores were compared pre- and postoperatively. Perioperative complications and the presence of other spine surgeries before and after thoracic OLF surgery were also investigated. Results: Four midline and 15 unilateral paramedian approaches were performed. The average operative time per level was 99 min, with minor blood loss. Nine patients had a history of cervical or lumbar spine surgery before or after thoracic spine surgery. The mean pre- and postoperative NRS scores were 6.6 and 5.3, respectively. The mean recovery rate as per the mJOA score was 33.1% (mean follow-up period, 17.8 months), the recovery rates were significantly different between patients who underwent thoracic spine surgery alone (50.5%) and patients who underwent additional spine surgeries (13.7%). Regarding adverse events, one patient experienced dural tear, another experienced postoperative hematoma, and one other underwent reoperation for adjacent thoracic stenosis. Conclusion: Microendoscopic posterior decompression was applicable in limited type of thoracic OLF surgery including beak-shaped type and multi vertebral levels. However, whole spine evaluation is important to avoid missing other combined stenoses that may affect outcomes.

The projection of the thoracic nerve roots and their connection with intervertebral discs: a cadaver and radiological study

2019 ◽  
Vol 61 (8) ◽  
pp. 1050-1056
Author(s):  
Chao Jiang ◽  
Qiang Guo ◽  
Ze-Ming Sun ◽  
Ze-Xin Chen ◽  
Jia-Jing Xu ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
Sagittal Plane ◽  
Intervertebral Discs ◽  
Posterolateral Approach ◽  
Nerve Roots ◽  
Anatomical Features ◽  
Thoracic Nerve ◽  
Dural Sac ◽  
Transforaminal Endoscopic Surgery

Background The anatomical features of the thoracic nerve roots in connection with intervertebral discs may prevent surgery-related complications and improve patients’ neurological functional status during thoracic spine surgery. There is limited literature evidence regarding this concept using cadavers. Purpose To elucidate the qualitative anatomical features of the thoracic nerve roots in connection with intervertebral discs. Material and Methods Fifteen formalin-preserved spine specimens were used in this study. Small pieces of stainless-steel wires were placed along the root sleeves from their points of origin, after exposing the dural sac and bilateral nerve roots. The standard anteroposterior and lateral radiographs were taken after the placement of the wires. Measurements were done on radiographs using the picture archiving communication system. Results Take-off angles of the nerve roots at the coronal plane gradually increased from the level of T2 (36.1°±2.72°) to T9 (84.1°±1.84°) and from T9, it decreased to T12 (46.3° ± 2.67°). Similar variation tendency was discovered in take-off angles of the nerve roots at the sagittal plane. No consistent tendency was found both in the distance from the origin of the root sleeve to its superior and inferior vertebral endplate. Distance from the origin of the root sleeve to the posterior midline (DM) exponentially decreased from T1 (8.2 ± 0.87 mm) to T4 (6.0 ± 0.93 mm). It slowly increased from T5 (5.5 ± 0.68 mm) to T12 (10.9 ± 1.79 mm), with T5 having the smallest DM. Distance between the origins of neighboring nerve roots showed an obvious increase from the T1–T2 interval (23.1 ± 2.22 mm) to T7–T8 interval (30.9 ± 2.68 mm). However, it progressively decreased at the T10–T11 interval (26.0 ± 2.40 mm). Conclusion The dimensions of the thoracic nerve roots vary greatly from T1 to T12 intervertebral discs. Sound knowledge of these anatomical features of the thoracic nerve is mandatory for the thoracic spine surgery, especially in the posterolateral approach and transforaminal endoscopic surgery.

The acute motor-sensory axonal neuropathy variant of Guillain-Barré syndrome after thoracic spine surgery

2011 ◽  
Vol 15 (6) ◽  
pp. 605-609 ◽  
Author(s):  
Jocelyn Cheng ◽  
D. Ethan Kahn ◽  
Michael Y. Wang
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Acute Motor Axonal Neuropathy ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Classic Form ◽  
Guillain Barré ◽  
New Onset

Guillain-Barré syndrome (GBS) is the eponym used to describe acute inflammatory polyradiculoneuropathies, which manifest with weakness and diminished reflexes. Although the classic form of GBS is considered to be an ascending demyelinating polyneuropathy, several variants have been described in the literature, including the Miller-Fisher syndrome, acute panautonomic neuropathy, acute motor axonal neuropathy, and acute motor-sensory axonal neuropathy (AMSAN). Few cases of postoperative GBS have been documented, particularly for the AMSAN variant. The authors describe the case of a patient who developed AMSAN after thoracic spine surgery and highlight the importance of investigating new-onset weakness in the postoperative period.

scholarly journals Focal Muscle Spasms after Thoracic Spine Surgery for Schwannoma: The Twitching Scar

2020 ◽  
Vol 13 (2) ◽  
pp. 168-170
Author(s):  
Paulo Eduardo Mestrinelli Carrilho ◽  
Marcius Benigno Marques dos Santos
Keyword(s):  
Spine Surgery ◽  
Thoracic Spine ◽  
Muscle Spasms

scholarly journals Iatrogenic Harlequin syndrome after thoracic spine surgery: a case report and literary review

2021 ◽  
Author(s):  
Zeyad Abousabie ◽  
Mohamed Almzeogi ◽  
aleksandar janicijevic ◽  
Jelena Kostic ◽  
Goran Tasic
Keyword(s):  
Case Report ◽  
Spine Surgery ◽  
Thoracic Spine ◽  
Tumor Resection ◽  
Sympathetic Nerves ◽  
Unique Case ◽  
Neurosurgical Procedure ◽  
Horner Syndrome ◽  
Harlequin Syndrome ◽  
Intradural Tumor

Here we present a unique case of Harlequin syndrome without Horner syndrome after contralateral Th3 intradural tumor resection. Harlequin sign in our case presented probably to resection of sympathetic nerves while removing meningioma. Syndrome is rare in neurosurgical procedure, but we think that surgeons must be aware of it.

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