Posterior Surgical Approach to the Lumbar Spine and Its Effect on the Multifidus Muscle

Weber, Barbara R.; Grob, Dieter; Dvořák, Jiří; Müntener, Markus

doi:10.1097/00007632-199708010-00017

Cited by 189 publications

(114 citation statements)

References 22 publications

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“…However, in the conventional midline approach, extensive muscle dissection and retraction leads to subsequent denervation and atrophy of the back muscles and may contribute to postoperative pain syndrome, such as fusion disease [24][25][26]. MITLIF, which is supposed to solve the above-mentioned Fig.…”

Section: Resultsmentioning

confidence: 99%

Comparison of minimally invasive versus open transforaminal lumbar interbody fusion in two-level degenerative lumbar disease

Zhang

Fan

et al. 2013

International Orthopaedics (SICOT)

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Section: Resultsmentioning

confidence: 99%

Comparison of minimally invasive versus open transforaminal lumbar interbody fusion in two-level degenerative lumbar disease

Zhang

Fan

et al. 2013

International Orthopaedics (SICOT)

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“…It has been demonstrated that these iatrogenic injuries lead to a diminishment of postoperative axial muscle strength and performance [19,47] damaging the cervical musculature, the primary force for the extension of the head on the cervical spine [14]. The trauma of surgery weakens the posterior tension band, decreasing its ability to withstand the forces needed to maintain alignment, and so producing iatrogenic sagittal plane destabilization that may lead to a progressive spinal deformity [14,34].…”

Section: Discussionmentioning

confidence: 99%

Less invasive approaches for the treatment of cervical schwannomas: our experience

et al. 2011

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Purpose The purpose of our paper is to illustrate our experience with minimally invasive approaches for the treatment of cervical schwannomas. Moreover, a brief review of the literature was conducted. Methods All data regarding patients treated for cervical schwannomas were retrospectively revised. Site, size and extension of the lesions and preoperative neurological status were obtained through re-examination of neuroimaging and clinical records. Postoperative clinical examinations and radiological images were available for all patients. The clinical course was documented using the visual analog scale (VAS), Karnofsky score (KPS) and the Klekamp-Samii score system. Results Sixteen patients harboring cervical schwannomas were treated from 2003 to 2009. Hemilaminectomy was performed in eight cases, subtotal hemilaminectomy in four cases, interlaminar fenestration in two cases, osteoplastic hemilaminotomy and laminoplasty in one case each. Postoperative neuroimaging revealed complete removal of the lesion and no signs of spinal instability. At discharge, neurological improvement was observed in 14 patients and all patients demonstrated reduction of VAS score and improvement of KPS and Klekamp-Samii's score. Conclusions Minimal access procedures are increasingly gaining popularity but their use is poorly described in the treatment of cervical tumors. Less invasive approaches may effectively be used instead of traditional laminectomy in the treatment of cervical tumors, especially schwannomas, providing less iatrogenic traumatism and preventing postsurgical spinal instability. Modern neuroimaging allows adequate preoperative planning and microsurgical techniques provide adequate execution of the surgical act. The procedure has to be tailored case by case considering the specific lesional features and the individual anatomical situation.

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“…This conventional surgery may be an alternative to minimal invasive procedures but has significant morbidity due to high intraoperative blood loss, increased infection rates, and extensive dissection of the paraspinous muscles. The last may result in paraspinal muscle denervation or severe multifidus muscle atrophy that should be taken into consideration [4,5]. Minimally invasive stabilization may therefore be a better choice.…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Stabilization for Thoracolumbar Fractures

SarÄ±kafa¹,

Demirkol²,

Peker³

et al. 2013

J Spine

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Minimally invasive approaches are becoming increasingly widespread due to numerous potential advantages (smaller scars, diminished local pain, reduced blood loss, reduced postoperative wound pain, shorter hospital stays) in spinal surgery. Nowadays, minimally invasive stabilization is more frequently used to treat some thoracolumbar fractures. The aim of this study is to explore the feasibility and effect of minimally invasive stabilization for the treatment of unstable thoracolumbar fractures without neurological impairment. From October 2011 to February 2012, 20 patients with thoracolumbar fracture who were treated with minimally invasive stabilization were included in this study. Charts and operative notes were analyzed for epidemiological data, injured segments, operative time, bleeding volume, mobilization interval, complications and lengths of stay. All patients were successfully managed with minimally invasive stabilization. There were 14 males and 6 females with a mean age of 33.75 years ranging from 18 to 59 years. The L1 vertebra was the most injured vertebral level (35%), followed by T12 and L2. Mechanisms of injury included falling from a height (12 patients) and traffic accidents (8 patients). The average operative time was 72 minutes (range 60 to 122 min). The average intraoperative blood loss was 80 ml (range 50 to 270 ml). Minimally invasive instrumentation of the spine reduces intraoperative blood loss, soft tissue trauma, operative time, infection rates and hospital stay. Future developments in minimally invasive technology will lead to improved results with increased indications and applications.

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Posterior Surgical Approach to the Lumbar Spine and Its Effect on the Multifidus Muscle

Cited by 189 publications

References 22 publications

Comparison of minimally invasive versus open transforaminal lumbar interbody fusion in two-level degenerative lumbar disease

Comparison of minimally invasive versus open transforaminal lumbar interbody fusion in two-level degenerative lumbar disease

Less invasive approaches for the treatment of cervical schwannomas: our experience

Minimally Invasive Stabilization for Thoracolumbar Fractures

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