Posterior only approach for fifth lumbar corpectomy: indications and technical notes

Elnady, Belal; Shawky, Ahmad Fathalla; Abdelrahman, Hamdan; Elmorshidy, Essam; El-Meshtawy, Mohamed; Said, Galal Z.

doi:10.1007/s00264-017-3570-7

Cited by 19 publications

(14 citation statements)

References 14 publications

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“…The posterior approach to the spine is simple, extensile, and familiar to all spine surgeons with little risk of vascular or visceral complications [8]. This saved our patient from combined approaches or staged surgeries and their morbidity [9,10].…”

Section: Discussionmentioning

confidence: 97%

Giant intrathoracic ganglioneuroma with scoliosis treated by one-stage posterior resection and scoliosis correction: a case report

Elnady

Abdelgawaad

Elkhayat

2020

SICOT-J

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Spinal ganglioneuroma occurs mostly in the thoracic spine causing various manifestations including scoliosis that can be misdiagnosed as idiopathic scoliosis. Few reports exist in the literature on the diagnosis and management of scoliosis secondary to huge ganglioneuroma and usually staged treatment is preferred. In this report, we present a 17-year-old female patient presented with back pain, lower limbs numbness, spinal deformity, and shortness of breath. Plain X-rays showed a 50° right thoracic scoliotic curve. MRI and chest CT revealed a huge extra pulmonary mass shifting the mediastinum with intra spinal extension through the left neural foramina compressing the spinal cord. Percutaneous US guided needle biopsy confirmed the diagnosis of ganglioneuroma. One-stage posterior instrumented correction of scoliosis, spinal cord decompression, and excision of the whole mass from the mediastinum and the spine through posterior approach was done for the patient with smooth postoperative recovery. Chest CT scan was done 2 years after surgery and excluded any local recurrence.

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Section: Discussionmentioning

confidence: 97%

Giant intrathoracic ganglioneuroma with scoliosis treated by one-stage posterior resection and scoliosis correction: a case report

Elnady

Abdelgawaad

Elkhayat

2020

SICOT-J

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“…L5 corpectomy from the anterior approach was first reported by Gaines in 1985, but this technique was applied only for high-grade spondylolisthesis cases [ 14 ]. L5 corpectomy is currently applied for burst fractures [ 2 , 15 ], infections [ 2 , 16 ], and tumors [ 15 , 17 ]. In our patient, surgery was performed in the lateral decubitus position to avoid the need to change position and drapes for anterior and posterior procedures, thereby reducing the operative time, risks of contamination, and inconvenience of re-registration for navigation purposes.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive L5 Corpectomy with Navigated Expandable Vertebral Cage: A Technical Note

et al. 2021

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Background: Conventional L5 corpectomy requires a large incision and an extended period of intraoperative fluoroscopy. We describe herein a new L5 corpectomy technique. Methods: A 79-year-old woman was referred to our hospital for leg pain and lower back pain due to an L5 vertebral fracture. Her daily life had been affected by severe lower back pain and sciatica for more than 2 months. We initially performed simple decompression surgery, but this proved effective for only 10 months. Results: For revision surgery, the patient underwent minimally invasive L5 corpectomy with a navigated expandable cage without fluoroscopy. The second surgery took 215 min, and estimated blood loss was 750 milliliters. The revision surgery proved successful, and the patient could then walk using a cane. In terms of clinical outcomes, the Oswestry Disability Index improved from 66% to 24%, and the visual analog scale score for lower back pain improved from 84 to 31 mm at the 1-year follow-up. Conclusions: Minimally invasive L5 corpectomy with a navigated expandable vertebral cage is effective for reducing cage misplacement and surgical invasiveness. With this new technique, surgeons and operating room staff can avoid the risk of adverse events due to intraoperative radiation exposure.

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“…The posterior-only approach for L5 corpectomy with expandable cage placement was found in literature to be performed in the setting of metastasis, trauma, and infection [15][16][17][18]. Hunt et al described the transpedicular approach in the setting of a three-column metastasis of L5 [17].…”

Section: Discussionmentioning

confidence: 99%

“…In certain cases, however, anterior approaches may be anatomically unfeasible or contraindicated due to abdominal anatomy or risk of vascular injury. Posterior-only L5 corpectomy is a challenging procedure but may offer the potential of less morbidities, faster operating time, and faster rehabilitation in comparison to the anterior or combined approaches [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

L5 Fracture Dislocation Secondary to Cold Abscess Treated by Posterior Corpectomy With Expandable Cage Placement

McFarland¹,

Branch²,

González³

et al. 2020

Cureus

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Infections of the lumbar spine can have serious sequelae, including neurological deficits, paralysis, and death. Prolonged infection can result in fracture of the vertebrae, local abscesses, and infiltration and compression of local vascular structures. In cases with significant instability or neurological compromise, a common treatment approach is vertebral corpectomy with interbody cage followed by long-term antibiotics. The following case describes a patient with a three-month history of progressively worsening lower back pain, lower extremity radiculopathy, and bilateral lower extremity edema, in the setting of a nontraumatic three-column fracture dislocation of L5 with grade 4 retrolisthesis of L4 on L5. A posterior-only corpectomy with placement of an expandable cage, to be followed by pedicle screw placement from L3-S1/ilium, was performed. The procedure was successful, and the patient was discharged on postoperative day 5 without complication and with resolution of his edema. Histopathological analysis demonstrated acute and chronic inflammation, but extensive tests and cultures failed to identify a causative organism. This case highlights several interesting features, including a technically challenging and seldom-performed procedure, as well as the ability of lumbar spinal infections to present with leg edema due to involvement the inferior vena cava and iliac vessels. For patients with three-column fractures of L5 due to an inflammatory process or trauma, a single-stage posterior corpectomy with placement of an expandable cage may be considered as an appropriate treatment option.

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Posterior only approach for fifth lumbar corpectomy: indications and technical notes

Cited by 19 publications

References 14 publications

Giant intrathoracic ganglioneuroma with scoliosis treated by one-stage posterior resection and scoliosis correction: a case report

Giant intrathoracic ganglioneuroma with scoliosis treated by one-stage posterior resection and scoliosis correction: a case report

Minimally Invasive L5 Corpectomy with Navigated Expandable Vertebral Cage: A Technical Note

L5 Fracture Dislocation Secondary to Cold Abscess Treated by Posterior Corpectomy With Expandable Cage Placement

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