Revision surgery for posterior stabilized thoracolumbar fracture using mini-open anterior approach and expandable cage.

Revision surgery for posterior stabilized thoracolumbar fracture using mini-open anterior approach and expandable cage. Orthop Surg. 2010 May;2(2):100-5 Authors: Zhao J, Schaser KD, Zhang F Abstract OBJECTIVE: To evaluate the surgical techniques and outcomes of revision surgery for compromised posterior stabilization or insufficient neurological decompression using anterior mini-open approach and expandable cage. METHODS: From August…

Anterior debridement and reconstruction via thoracoscopy-assisted mini-open approach for the treatment of thoracic spinal tuberculosis: minimum 5-year follow-up.

Anterior debridement and reconstruction via thoracoscopy-assisted mini-open approach for the treatment of thoracic spinal tuberculosis: minimum 5-year follow-up.

Eur Spine J. 2011 Oct 14;

Authors: Lü G, Wang B, Li J, Liu W, Cheng I

Abstract
INTRODUCTION: Video-assisted thoracoscopic surgery (VATS) has been developed for surgical treatment of thoracic spinal tuberculosis to overcome the problems associated with a formal thoracotomy. VATS, however, is technically demanding with a difficult learning curve. MATERIALS AND METHODS: We conducted a retrospective long-term follow-up study of anterior debridement and reconstruction via a thoracoscopy-assisted mini-open approach for the surgical treatment of thoracic spinal tuberculosis. There were 50 patients collected with mean age 38.3 years with thoracic spinal tuberculosis. RESULTS: The average operative time was 210 min (range 170-300 min), the average blood loss during operation was 550 ml (range 300-1,000 ml), and the mean chest drainage duration was 3.5 days (3-5 days). Complications occurred in 17 patients (34%). The mean follow-up was 6.5 years. There was statistically difference in VAS 3 months after surgery compared to preoperatively (P < 0.001), as well as final follow-up compared to 3 months post-op (P < 0.001). In patients with minor pulmonary impairment as measured by pulmonary function testing, 15 improved to normal and 5 had no change. In patients with moderate pulmonary impairment, 6 improved to normal and 2 improved to minor impairment at final follow-up. Neurological improvement of one to three grades had occurred in 26 patients by final follow-up. There was statistically difference in kyphotic angle 3 months after surgery compared to preoperatively (P < 0.05), as well as final follow-up compared to 3 months post-op (P < 0.001). The average correction rate of kyphotic angle was 38.7% and the loss of correction rate was 1.3% at final follow-up. No recurrent tuberculosis was found. CONCLUSION: Thoracoscopy-assisted mini-open approach can provide a simple, safe, and practical treatment option with minimal invasiveness in cases of thoracic spinal tuberculosis. Successful clinical and radiographic outcomes can be achieved via anterior debridement and reconstruction at long-term follow-up.

PMID: 21997276 [PubMed – as supplied by publisher]

The transspinous mini-open approach for resection of intradural spinal neoplasms: cadaveric feasibility study and report of 3 clinical cases.

The transspinous mini-open approach for resection of intradural spinal neoplasms: cadaveric feasibility study and report of 3 clinical cases.

World Neurosurg. 2010 Jul;74(1):195-9

Authors: Lu DC, Dhall SS, Mummaneni PV

Standard approaches to thoracic intradural tumors often involve a large incision and significant tissue destruction. Minimally invasive techniques have been applied successfully for a variety of surgical decompression procedures but have rarely been used for the removal of intradural thoracic tumors. Here, we demonstrate the feasibility and initial clinical experience with a new minimally invasive approach for resection of intradural tumors.

PMID: 21300013 [PubMed – indexed for MEDLINE]