The Corpectomy Using Minimally Invasive Access in Thoracolumbar Fractures

Abstract

Introduction: In our clinic for several years we are pursuing the concept of mini-invasive surgery applied to the spine. Increasingly we have to our attention patients with comorbidities (figure 1) and for this reason could not face a major surgery. In this work we analyze various patients who suffered an osteoporotic vertebral fracture. The fractures on CT and MRI study, presented a minimal back protrusion of the wall with no images related to compression of the structures ( figure 2a, 2b, 2c), but presented deformities,like kyphosis. The deformities in the past would certainly have required anterior surgery and corpectomy with placement of a mesh and interbody stabilization. This method provides access to trans-abdominal peritoneal or retro peritoneal and often requires the collaboration of general and vascular surgeon due to the presence of abdominal viscera and major vessels.

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

“…5,[9][10][11]15 As demonstrated in this study and other studies, there was noticeable improvement in VAS score postoperatively. 9,14,15 Other studies have also documented improvement in neurological function, 5,13 Oswestry Disability Index, 15 lumbar lordosis, 11 and kyphosis angle. 14 We identified only 1 comparative study between open and minimally invasive TL corpectomy.…”

“…In fact, most published studies on this topic are case series. 5,[9][10][11]15 As demonstrated in this study and other studies, there was noticeable improvement in VAS score postoperatively. 9,14,15 Other studies have also documented improvement in neurological function, 5,13 Oswestry Disability Index, 15 lumbar lordosis, 11 and kyphosis angle.…”

Anterior Approach for Lesions in the Thoracolumbar Area: Evaluation of the Clinical and Radiological Outcome

“…18,19 However the use of anterior approach for the treatment of thoracolumbar spine disease has several limitations a) the incidence rate of transient intercostal neuralgia and pulmonary complications, such as postoperative atelectasis, pneumothorax, pleural effusion, and hemothorax has been reported to be (14.1-29.4%). 4,5,20 However in this study the incidence was 13.3% for pneumothorax and 6.7 % for hemothorax.…”

“…Nevertheless, with the advent of anti-tuberculous antibiotic therapy, a decline in the number of cases led to less need for this procedure. 4 In this series the surgical indication was due to neurological deterioration in two patients, epidural abscess in two patients and progressive deformity in one patient. Placement of instrumentation in an infected area and the increased risk of deep wound infection had resulted in the controversy of the twostages surgery, debridement/bone grafting then delayed instrumentation, versus the debridement/ bone grafting and instrumentation at the same sitting.…”