20 Minimally Invasive Lumbar Corpectomy

✓ The anterior decompressive procedure in which spinal fusion is performed is considered an effective treatment for thoracolumbar fractures and tumors. However, it is also known to be associated with considerable surgery-related trauma. The purpose of this study was to show that lumbar corpectomy and anterior reconstruction can be performed via a minimally invasive retroperitoneal approach (MIRA) and therefore the surgical approach—related trauma can be reduced. The authors studied retrospectively the hospital records and radiological studies obtained in five patients (mean age 67.4 years, range 59–76 years) who underwent lumbar corpectomy and spinal fusion via an MIRA followed by posterior fixation. Four patients presented with osteoporotic compression fractures at L-2 and L-3, and one patient presented with metastatic disease in L-4 from prostate cancer. Neurological deficits due to cauda equina compression were demonstrated in all patients. The MIRA provided excellent exposure to facilitate complete decompression and anterior reconstruction in all patients, as verified on follow-up radiographic studies. All patients improved clinically. A 1-year follow-up record is available for four patients and a 6-month follow-up record for the fifth patient; continuing clinical improvement has been observed in all. Radiography demonstrated anatomically correct reconstruction in all patients, as well as a solid fusion or a stable compound union in the four patients for whom 1-year follow-up records were available. The MIRA allows the surgeon to perform anterior lumbar spine surgery via a less invasive approach. The efficacy and safety of this technique and its potential to reduce perioperative morbidity compared with conventional retroperitoneal lumbar spine surgery should be further investigated in a larger series.

Download Full-text

Minimally invasive lateral transpsoas approach for lumbar corpectomy and stabilization

Surgical Neurology International ◽

10.25259/sni_292_2019 ◽

2019 ◽

Vol 10 ◽

pp. 153

Author(s):

Umesh Srikantha ◽

Yadhu Kasetti Lokanath ◽

Akshay Hari ◽

S. Nirmala ◽

Ravi Gopal Varma

Keyword(s):

Minimally Invasive ◽

Interbody Fusion ◽

Compression Fracture ◽

Early Mobilization ◽

Tubular Retractor ◽

Lateral Interbody Fusion ◽

Transpsoas Approach ◽

Lateral Interbody ◽

Anterior Column Reconstruction ◽

Lumbar Corpectomy

Background: Here, we present our experience with the minimally invasive (MI) transpsoas approach for lumbar corpectomy and stabilization. Transpsoas approach accesses the lumbar spine and includes both the direct lateral interbody fusion and extreme lateral interbody fusion techniques. Both procedures utilize a tubular retractor system which facilitates adequate retraction and direct visualization of the target, while supposedly reducing soft tissue trauma. Case Description: We evaluated two patients, one with a traumatic L2 wedge compression fracture and the other with an L3 pathological compression fracture due to multiple myeloma. Both patients underwent MI transpsoas lumbar corpectomy, anterior column reconstruction with an expandable cage, and posterior pedicle screw instrumentation to correct a kyphotic deformity. Both patients were mobilized on the 1st postoperative day and experienced significant postoperative pain relief. Conclusion: In two cases involving L2 and L3 compression fractures, MI transpsoas lumbar corpectomy was safely performed, with reduced perioperative and postoperative morbidity. Here, the transpsoas approach also allowed for early mobilization, adequate postoperative biomechanical stability, and resulted in immediate good outcomes.

Download Full-text

52 Minimally invasive proceduresanterior lumbar corpectomy inLumbar corpectomy, anteriorminimally-invasive lateralCorpectomyanterior lumbarminimally-invasive lateralAnterior lumbar corpectomyminimally-invasive lateralAnterior Lumbar Corpectomy via a Minimally Invasive Lateral Approach

Spine Surgery ◽

10.1055/b-0036-132143 ◽

2016 ◽

Keyword(s):

Minimally Invasive ◽

Lateral Approach ◽

Lumbar Corpectomy

Download Full-text

Minimally invasive retroperitoneal approach for lumbar corpectomy and reconstruction

Neurosurgical FOCUS ◽

10.3171/foc.1999.7.6.7 ◽

1999 ◽

Vol 7 (6) ◽

pp. E6 ◽

Cited By ~ 7

Author(s):

Manfred Mühlbauer ◽

Wolfgang Pfisterer ◽

Richard Eyb ◽

Engelbert Knosp

Keyword(s):

Lumbar Spine ◽

Minimally Invasive ◽

Spinal Fusion ◽

Spine Surgery ◽

Surgical Approach ◽

Retroperitoneal Approach ◽

Lumbar Spine Surgery ◽

Spinal Reconstruction ◽

Lumbar Corpectomy

Anterior decompressive surgery with spinal fusion is considered an effective treatment for thoracolumbar fractures and tumors. However, it is also known to be associated with considerable surgical approach–related trauma. The purpose of this study was to show that lumbar corpectomy and spinal reconstruction can be performed via a minimally invasive retroperitoneal (MIR) approach and therefore, the surgical approach–related trauma can be reduced. The hospital records and radiological studies obtained in five patients (mean age 67.4 years, range 59-76 years) who underwent lumbar corpectomy and spinal fusion via an MIR approach were studied retrospectively. Four patients presented with osteoporotic compression fractures at L-2 and L-3 and one patient with metastatic disease at L-4 from prostate cancer. In all patients neurological deficits due to cauda equina compression were demonstrated. The MIR approach provided excellent exposure to facilitate complete spinal decompression and reconstruction in all patients, as verified on follow-up x-ray studies. All patients improved clinically. A 1-year follow-up record, available for four patients, showed evidence of continuing clinical improvement and, radiographically, a solid fusion or a stable compound union and anatomically correct reconstruction. The MIR approach allows anterior lumbar spine surgery to be performed less invasively. The efficacy and safety of this technique compared with the conventional retroperitoneal approach to lumbar spine surgery should be further investigated in a larger series.

Download Full-text

22 Minimally Invasive Lumbar Corpectomy

Pocket Atlas of Spine Surgery ◽

10.1055/b-0034-74682 ◽

2012 ◽

Keyword(s):

Minimally Invasive ◽

Lumbar Corpectomy

Download Full-text

Acute Lumbar Burst Fracture Treated by Minimally Invasive Lateral Corpectomy

Case Reports in Orthopedics ◽

10.1155/2013/953897 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Rodrigo Amaral ◽

Luis Marchi ◽

Leonardo Oliveira ◽

Thiago Coutinho ◽

Luiz Pimenta

Keyword(s):

Minimally Invasive ◽

Burst Fracture ◽

Pedicle Screws ◽

Difficult Problem ◽

Lateral Approach ◽

Radiological Results ◽

High Incidence ◽

Clinical And Radiological Results ◽

Mini Open ◽

Lumbar Corpectomy

Burst fractures in acute spinal traumas are a difficult problem to solve. Different approaches and techniques have been utilized, but with high incidence of morbidity and mortality, besides unsatisfactory clinical and radiological results. Mini-open approaches recently emerged and have been shown to be safe and effective in the treatment of several spinal conditions. Here we report a case of acute lumbar burst fracture at L2 treated by minimally invasive true lateral approach posteriorly instrumented with percutaneous pedicle screws. The minimum disruptive access in addition to a rigid construction allowed a lumbar corpectomy without the morbidity of standard open approaches, lowering surgery costs and accelerating the patient recovery with successfully clinical and radiological results.

Download Full-text

Considerations in Dysphagia Management Following Esophagectomy

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig13.169 ◽

2016 ◽

Vol 1 (13) ◽

pp. 169-176

Author(s):

Lisa M. Evangelista ◽

James L. Coyle

Keyword(s):

Esophageal Cancer ◽

Minimally Invasive ◽

Minimally Invasive Surgical Procedures ◽

Esophageal Resection ◽

Minimally Invasive Surgical ◽

Operative Complications ◽

Swallowing Difficulties ◽

Epidemiological Impact ◽

Invasive Techniques ◽

Management Of Dysphagia

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.

Download Full-text