P70. Scheuermann's Kyphosis—Single Posterior Approach or Anterior Release and Posterior Instrumentation?

2006 ◽  
Vol 6 (5) ◽  
pp. 117S ◽  
Author(s):  
Peter Metz-Stavenhagen ◽  
Luis Ferraris ◽  
Stefan Krebs ◽  
Axel Hempfing
Keyword(s):  
Posterior Approach ◽  
Posterior Instrumentation ◽  
Anterior Release ◽  
Scheuermann’S Kyphosis ◽  
Single Posterior Approach

scholarly journals Correction of adult scoliosis via a posterior-only approach

2003 ◽  
Vol 14 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Caleb R. Lippman ◽  
Caple A. Spence ◽  
A. Samy Youssef ◽  
David W. Cahill
Keyword(s):  
Posterior Instrumentation ◽  
Posterior Lumbar Interbody Fusion ◽  
Adult Scoliosis ◽  
Adjacent Segment ◽  
Anterior Release ◽  
Second Procedure ◽  
Single Posterior Approach ◽  
Upper Thoracic ◽  
Coronal Malalignment ◽  
Adjacent Segments

Object Adult scoliosis is a pathologically different entity from adolescent idiopathic scoliosis. The curves are more rigid, and rotational deformity and multilevel sagittal vertebral slippages compound the coronal malalignment. To correct these deformities, a surgical anterior release procedure is usually required, as well as posterior instrumentation-assisted fusion. This exposes the patient to the risks of a second procedure and of a thoracotomy or laparotomy. To decrease these risks, the authors have performed an anterior release, posterior release, and reduction via a posterior-only approach. The purpose of this study was to analyze quantitatively the degree of pre- and postoperative coronal deformity, the extent of correction, and related complications. Methods Data obtained in 20 patients with adult scoliosis were retrospectively studied. Patients presented with persistent back or lower-extremity pain, progressive deformity, or progressive neurological deficit. Sixteen patients underwent Gill-type laminectomy, radical discectomy (including fracture of any anterior and lateral osteophytes), and posterior lumbar interbody fusion (PLIF) of all apical and adjacent segments. One to four anterior release procedures were performed in each patient. Posterior instrumentation was placed over three to 15 levels. Autograft was obtained from the laminectomy sites and posterior iliac crest for fusion. There were no deaths; all patients were followed for a minimum of 1 year. The mean coronal Cobb angle improved from 36° to 14.7°. All spondylolisthetic lesions were reduced to at least Grade I. At the most recent follow-up examination, evidence of fusion was demonstrated in all patients. Reoperation for adjacent-segment failure, cephalad to the highest level of fusion, was required in two cases. Conclusions In many cases of adult scoliosis, a satisfactory multiplanar correction may be obtained via a single posterior approach and by using extended PLIF techniques. Cephalad adjacent-segment failure remains a significant problem in patients with osteoporosis, and routine extension of posterior instrumentation to the upper thoracic spine should be considered in these cases.

scholarly journals Reduction and fusion in high-grade L5-S1 spondylolisthesis by a single posterior approach. Results in 50 patients

2016 ◽  
Vol 102 (2) ◽  
pp. 233-237 ◽  
Author(s):  
S. Moreau ◽  
G. Lonjon ◽  
P. Guigui ◽  
T. Lenoir ◽  
C. Garreau de Loubresse ◽  
...  
Keyword(s):  
Posterior Approach ◽  
High Grade ◽  
Single Posterior Approach

Minimally invasive tubular surgery for transforaminal lumbar interbody fusion

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video19 ◽  
Author(s):  
Jon Kimball ◽  
Andrew Yew ◽  
Ruth Getachew ◽  
Daniel C. Lu
Keyword(s):  
Minimally Invasive ◽  
Posterior Approach ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Postoperative Patient ◽  
Common Procedure ◽  
Circumferential Fusion ◽  
Single Posterior Approach ◽  
Invasive Techniques

Transforaminal lumbar interbody fusion (TLIF) was originally developed as a method for circumferential fusion via a single posterior approach and is now an extremely common procedure for the treatment of lumbar instability. More recently, minimally invasive techniques have been applied to this procedure with the goal of decreasing tissue disruption, blood loss and postoperative patient discomfort. Here we describe a minimally invasive tubular TLIF on a 60-year-old male with radiculopathy from an unstable L4–5 spondylolisthesis.The video can be found here: http://youtu.be/0BbxQiUmtRc.

scholarly journals SCHEUERMANN'S KYPHOSIS: COMPARISON BETWEEN THE POSTERIOR APPROACH ASSOCIATED WITH SMITH-PETERSEN OSTEOTOMY AND COMBINED ANTERIOR-POSTERIOR FUSION

2011 ◽  
Vol 46 (6) ◽  
pp. 709-717 ◽  
Author(s):  
Eduardo Frois Temponi ◽  
Rodrigo D'Alessandro de Macedo ◽  
Luiz Olímpio Garcia Pedrosa ◽  
Bruno Pinto Coelho Fontes
Keyword(s):  
Posterior Approach ◽  
Posterior Fusion ◽  
Scheuermann’S Kyphosis ◽  
Anterior Posterior

Mini-open transpedicular corpectomies with expandable cage reconstruction

2011 ◽  
Vol 14 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Dean Chou ◽  
Daniel C. Lu
Keyword(s):  
Minimally Invasive ◽  
Posterior Approach ◽  
Pedicle Screws ◽  
Anterior Surgery ◽  
Trap Door ◽  
Expandable Cage ◽  
Unilateral Approach ◽  
Single Posterior Approach ◽  
Rib Head ◽  
Mini Open

Transpedicular corpectomies are frequently used to perform anterior surgery from a posterior approach. Minimally invasive thoracolumbar corpectomies have been previously described, but these are performed through a unilateral approach. Bilateral access must be obtained for a circumferential decompression when using such techniques. The authors describe a technique that allows for a mini-open transpedicular corpectomy, 360° decompression, and expandable cage reconstruction through a single posterior approach. This is performed using percutaneous pedicle screws, the trap-door rib-head osteotomy, and a single midline fascial exposure. The authors describe this technique with intraoperative photos and a video demonstrating the technique.

scholarly journals Treatment of subacute thoracic spine fracture-dislocation by total vertebrectomy and spine shortening

2013 ◽  
Vol 18 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Alecio C. E. S. Barcelos ◽  
Ricardo V. Botelho
Keyword(s):  
Posterior Approach ◽  
Posterior Instrumentation ◽  
Complete Recovery ◽  
Current Treatment ◽  
Fracture Dislocation ◽  
Fracture Dislocations ◽  
Thoracic Spine Fracture ◽  
Surgical Teams ◽  
Anterior Support ◽  
Vertebral Resection

Vertebral resection with spine shortening has been primarily reported for the treatment of demanding cases of nontraumatic disorders. Recently, this technique has been applied to the treatment of traumatic disorders. The current treatment of vertebral fracture-dislocation when there is partial or total telescoping of the involved vertebrae is a combined anterior-posterior approach with corpectomy, anterior support implant, and further posterior instrumentation. These procedures usually require 2 surgical teams, involve longer operating times and greater risk of surgical complications related to the anterior approach, and commonly entail longer postoperative care before discharge. The authors report on 2 patients with high thoracic fracture-dislocations with telescoping (T-2 and T-4) who were treated in the subacute phase with total spondylectomy (T-3 and T-5, respectively) and spine shortening by using only a posterior approach. Complete recovery of the sagittal balance was achieved with this technique and the postoperative periods were clinically uneventful. One patient presented with asymptomatic hemothorax that did not require drainage. In paraplegic patients with anterior thoracic dislocation fractures in which one vertebral body blocks the reduction of the other, total spondylectomy and spine shortening seem to be a reasonably safe and effective technique.

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