Minimally Invasive Lateral Corpectomy of the Thoracolumbar Spine: A Case Series of 20 Patients

Abstract

Study Design: Retrospective case series. Objective: To report our experience with corpectomy of the thoracolumbar (TL) spine through a minimally invasive lateral retropleural or retroperitoneal approach. Methods: This is a retrospective case series of 20 consecutive patients who underwent minimally invasive TL corpectomy and spinal reconstruction. Electronic medical records were reviewed for demographic, operative, and clinical outcome data. Results: Between 2015 and 2019, 20 consecutive cases of minimally invasive TL corpectomy were performed, comprising 12 men (60%) and 8 women (40%) with a mean age of 54.3 years. Indications for surgery were infection (n = 6, 30%), metastatic disease (n = 2, 10%), fracture (n = 6, 30%), and calcified disc herniation (n = 6, 30%). Partial and complete corpectomy was performed in 5 patients (25%) and 15 patients (75%), respectively. Mean operative time and estimated blood loss was 276.2 minutes and 558.4 mL, respectively. Mean length of stay from admission and surgery were 14.6 and 11.4 days, respectively. Mean length of stay from surgery for elective cases was 4.2 days. Mean follow-up time was 330.4 days. Visual analogue scale score improved from 7.7 to 4.5 ( P < .01). There were a total of 3 postoperative complications in 2 patients, including 1 mortality for urosepsis. One patient had revision spinal surgery for adjacent segment disease. Conclusions: Corpectomy and reconstruction of the TL spine is feasible and safe using a minimally invasive lateral retropleural or retroperitoneal approach. Since this is a relatively new technique, more studies are needed to compare the short- and long-term radiographic and clinical outcomes between minimally invasive versus open corpectomy of the TL spine.

Comparison of Navigated Expandable Vertebral Cage with Conventional Expandable Vertebral Cage for Minimally Invasive Lumbar/Thoracolumbar Corpectomy

“…Cage sinking in fluoroscopy guided corpectomy was reported by few authors [ 22 ]; One cage subsidence underwent revision [ 22 ]. Le et al reported a total of three postoperative complications which needed revision surgery for adjacent segment disease [ 23 ]. Smith et al reported mild radiographic subsidence of the anterior cage occurred in seven patients (13.5%), all with expandable cylindrical titanium cages, none with wide foot plate cages [ 24 ].…”

Minimally invasive corpectomy and percutaneous transpedicular stabilization in the treatment of patients with unstable injures of the thoracolumbar spine: Results of retrospective case series

“…The dominant goal of MISS is to reduce the complications associated with approach, while obtaining results comparable to traditional open surgery. [ 7 16 ] In the treatment of traumatic vertebral pathology, the main tasks remain decompression and prevention of the development of secondary damage to neural structures, ensuring segmental stability and reducing posttraumatic deformity. [ 4 ] Reconstruction of the physiological balance of the spine accelerates the recovery of clinical disorders and reduces the risk of worsening of existing neurological deficits.…”

Multilevel L4 and L5 Corpectomy for Burst Fracture via an Anterior Transperitoneal Approach Followed by Posterior Stabilization: Technical and Anatomic Considerations

“…There was a total of three postoperative complications in two patients, including one mortality for urosepsis. One patient had revision spinal surgery for adjacent segment disease [ 28 ]. Because our patient previously had several spine procedures, a transperitoneal anterior approach was felt to be the most appropriate technique to address the corpectomy of L4 and L5.…”