Tubular laminectomy and percutaneous vertebroplasty for aggressive vertebral hemangioma

Background: Vertebral hemangiomas (VH) are the most common benign vascular neoplasms of the spine. Aggressive VH (AVH) may become symptomatic due to soft-tissue expansion/extraosseous extension into the paraspinal and/or epidural spaces. There are several options for treating painful AVH, including radiotherapy and/or open surgery. Case Description: A 59-year-old male presented with a 2-year history of intermittent back pain and progressive thoracic myelopathy in the past 2 months. MRI revealed a T9 level lesion, with high-intensity signal on both T1 and T2 images and an extraosseous component with significant cord compression. We performed minimally invasive tubular unilateral laminotomy for bilateral decompression of the thoracic spine at the T9 level, followed by bilateral percutaneous vertebroplasty with biopsy. Postoperatively, the pain was immediately relieved, and the myelopathy improved. The biopsy confirmed the diagnosis of a VH. Conclusion: Combining minimally invasive techniques consisting of tubular laminectomy and percutaneous vertebroplasty are safe and effective ways for treating AVHs.

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A brief history of the development of laparoscopy and minimally invasive techniques

Pielęgniarstwo XXI Wieku ◽

10.12923/p21w-2015-2/23 ◽

2015 ◽

pp. 73-76

Author(s):

Piotr arzynkowski ◽

◽

Renata Piotrkowska ◽

Janina Książek ◽

Agnieszka Kruk

Keyword(s):

Minimally Invasive ◽

Minimally Invasive Techniques ◽

History Of ◽

Invasive Techniques

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Buschke-Löwenstein Tumour: Successful Treatment with Minimally Invasive Techniques

Case Reports in Dermatological Medicine ◽

10.1155/2015/651703 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Estefânia Correia ◽

António Santos

Keyword(s):

Minimally Invasive ◽

Cost Effective ◽

Functional Results ◽

Moderate Degree ◽

Minimally Invasive Techniques ◽

Secondary Intention ◽

History Of ◽

Full Thickness Excision ◽

Invasive Techniques

We report a case of an 80-year-old female who presented with a four-year history of a growing mass in the perianal area with pain and bleeding during defaecation. Clinical examination revealed a locally destructive, cauliflower-like, verrucous mass measuring 10×12 cm in diameter. Histologic findings revealed a moderate degree of dysplasia of the epithelium with koilocytosis atypia, acanthosis, and parakeratosis, features that are consistent with Buschke-Löwenstein tumour. Polymerase-chain-reaction assay for human papillomavirus (HPV) showed an infection with HPV type 11. Full-thickness excision of involved skin was undertaken by cryotherapy and electrocautery over five months. The entire wound was left open to heal by secondary intention. After 3 years of follow-up, the patient has not experienced a recurrence, with excellent functional results, but the cosmetic results were satisfactory. These minimally invasive techniques can be safer and more cost-effective than surgery and the General Practitioner can play a key role in diagnosis.

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History of Minimally Invasive Techniques for Radical Cystectomy with Urinary Diversion

Robotic Surgery of the Bladder ◽

10.1007/978-1-4614-4906-5_1 ◽

2013 ◽

pp. 1-4

Author(s):

Jan Colli ◽

Mathew Oommen ◽

Raju Thomas

Keyword(s):

Minimally Invasive ◽

Radical Cystectomy ◽

Urinary Diversion ◽

Minimally Invasive Techniques ◽

History Of ◽

Invasive Techniques

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Thoracic flexion myelopathy

Journal of Neurosurgery ◽

10.3171/jns.1995.82.6.1059 ◽

1995 ◽

Vol 82 (6) ◽

pp. 1059-1061 ◽

Cited By ~ 6

Author(s):

Kimihiko Mii ◽

Satoru Shimizu ◽

Chihiko Tanaka ◽

Kuniaki Matsumori ◽

Kazuko Hasegawa ◽

...

Keyword(s):

Thoracic Spine ◽

Cord Compression ◽

Posterolateral Fusion ◽

Neutral Position ◽

Thoracic Myelopathy ◽

Content Type ◽

History Of ◽

Fine Print

✓ A case of thoracic flexion myelopathy is reported in a 36-year-old man. The patient had a history of gradually progressing transverse thoracic myelopathy. Conventional myelography in the neutral position failed to reveal cord compression; however, a severe block of the dye column was evident on studies in the flexed position. Excellent recovery from this condition was obtained with posterolateral fusion of the thoracic spine in the neutral position.

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Descompresión medular mediante abordaje lateral transtorácico mínimamente invasivo. Reporte de un caso. [Spinal cord decompression by minimally invasive transthoracic lateral approach. Case report]

Revista de la Asociación Argentina de Ortopedia y Traumatología ◽

10.15417/issn.1852-7434.2019.84.1.833 ◽

2019 ◽

Vol 84 (1) ◽

pp. 70-74

Author(s):

Augusto Esteban Martínez ◽

Felipe Jose Lanari Subiaur ◽

Carlos María Mounier ◽

José Ricardo Prina ◽

Ramiro Gutiérrez ◽

...

Keyword(s):

Spinal Cord ◽

Minimally Invasive ◽

Thoracic Spine ◽

Cord Compression ◽

Lateral Approach ◽

Thoracic Vertebra ◽

Advantages And Disadvantages ◽

Spinal Cord Decompression ◽

Invasive Techniques

Existen múltiples técnicas para la descompresión medular en la columna torácica, cada una con sus ventajas y desventajas y con distintos requerimientos de destrezas quirúrgicas. Se han desarrollado técnicas mínimamente invasivas que disminuyen las tasas de morbilidad, con buenos resultados funcionales. Se presenta el caso de un hombre de 64 años, con clínica de compresión medular, una hernia de disco central, calcificada a nivel del quinto disco torácico, migrada hasta el borde inferior de la sexta vértebra torácica, con franca compresión medular. Se realizó un abordaje lateral transpleural mínimamente invasivo, con una corpectomía parcial posterior de la sexta vértebra, sin fijación adicional. El paciente tuvo una buena evolución, sin progresión del cuadro neurológico ni dolor costal residual.Los abordajes laterales mínimamente invasivos son técnicas válidas para tratar patologías compresivas de la columna torácica, con bajas tasas de morbimortalidad y una rápida recuperación. AbstractThere are multiple techniques for spinal cord decompression in the thoracic spine, each with its advantages and disadvantages, and requiring different surgical skills. Recently, minimally invasive techniques have been developed, reducing morbidity rates and achieving good functional results.We present the case of a 64-year-old male with spinal compression symptoms, central disc herniation calcified at the fifth thoracic vertebra, which migrated to the lower end of the sixth thoracic vertebra. Diagnosis was clear for spinal cord compression. Partial posterior corpectomy of the sixth vertebra was performed with a minimally invasive transthoracic transpleural lateral approach and without additional fixation. The patient had a good outcome on follow-up, without progression of neurological symptoms or residual rib pain.Minimally invasive lateral approaches are valid techniques for the treatment of compression disorders of the thoracic spine, with low rates of morbidity and mortality, and a rapid recovery.

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Percutaneous Cement Vertebroplasty in the Treatment of Symptomatic Vertebral Hemangiomas

January 2018 - Pain Physician ◽

10.36076/ppj.2012/15/43 ◽

2012 ◽

Vol 1;15 (1;1) ◽

pp. 43-49

Author(s):

ZhenMing Hu

Keyword(s):

Minimally Invasive ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

Invasive Technique ◽

Benign Tumors ◽

Clinical Effects ◽

Sf 36 ◽

Vertebral Bodies ◽

Vertebral Hemangiomas

Background: Vertebral hemangiomas are benign tumors with a rich vasculature. Symptoms may vary from simple vertebral pain, sometimes resistant to conservative medical treatment, to progressive neurological deficit. Surgery or radiotherapy have been the treatment of choice for several years, but they were worsened by intraoperative and postoperative hemorrhagic complications related to the rich vascularization that characterize these kinds of lesions, often preceded by a preoperative embolization in the acute setting. Recently, a percutaneous, minimally invasive technique of vertebroplasty has been introduced into clinical practice as an alternative to traditional surgical and radiotherapy treatment of symptomatic vertebral hemangiomas with or without features of aggressiveness at imaging studies. Objective: This study aimed to illustrate the validity of treatment with percutaneous vertebroplasty (PVP) in patients with symptomatic vertebral hemangiomas (VHs). Study Design: PVP in 26 patients with symptomatic VHs and its clinical effects were evaluated in 3-24 months follow-up. Setting: An inteventional pain management practice, a medical center, major metropolitan city, China. Methods: Twenty-six consecutive patients were treated with PVP; a total of 28 vertebral bodies. All patients were followed-up for 3-24 months, average 8.6 months. The clinical effects were evaluated with the visual analog scale (VAS) and 36-item short-form (SF-36) at preoperative and postoperative and final follow-up, comparing imaging before and post-treatment. Results: Twenty-six patients (28 vertebral bodies) were treated successfully with a satisfying resolution of painful symptoms within 24 to 72 hours. Cement distribution was always diffuse and homogeneous. We found paravertebral cement leakage in 3 cases without any onset of radicular symptoms related to epidural diffusion. Spinal canal and intervertebral foramen cement leakage wasn’t noticed. No pulmonary embolism ever occurred and no clinical and symptomatic complications were observed. Hemangioma was confirmed by pathology examination. VAS scores decreased from 7.5 ± 1.5 preoperatively to 1.6 ± 0.6 postoperatively, with a final score of 0.7 ± 0.5. There was significant difference between postoperative and preoperative, and between final followup and preoperative (P < 0.05). At the postoperative and final follow-up, the SF-36 scores of patients was significantly higher than the preoperative in Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health (P < 0.05). Limitations: An observational study with a relatively small sample size. Conclusions: PVP is an effective technique to treat symptomatic vertebral hemangioma, which is a valuable, minimally invasive, and quick method that allows a complete and lasting resolution of painful vertebral symptoms. Key words: Percutaneous vertebroplasty, symptomatic, vertebral, hemangiomas.

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Minimally invasive thoracoscopic approach for anterior decompression and stabilization of metastatic spine disease

Neurosurgical FOCUS ◽

10.3171/foc/2008/25/8/e8 ◽

2008 ◽

Vol 25 (2) ◽

pp. E8 ◽

Cited By ~ 47

Author(s):

Peter Kan ◽

Meic H. Schmidt

Keyword(s):

Spinal Cord ◽

Minimally Invasive ◽

Thoracic Spine ◽

Cord Compression ◽

Neurological Deficits ◽

Thoracoscopic Approach ◽

Small Series ◽

Spinal Cord Decompression ◽

Invasive Techniques ◽

Spine Disease

Object The choices available in the management of metastatic spine disease are complex, and the role of surgical therapy is increasing. Recent studies have indicated that patients treated with direct surgical decompression and stabilization before radiation have better functional outcomes than those treated with radiation alone. The most common anterior surgical approach for direct spinal cord decompression and stabilization in the thoracic spine is open thoracotomy; however, thoracotomy for spinal access is associated with morbidity that can be avoided with minimally invasive techniques like thoracoscopy. Methods A minimally invasive thoracoscopic approach was used for the surgical treatment of thoracic and thoracolumbar metastatic spinal cord compression. This technique allows ventral decompression via corpectomy, inter-body reconstruction with expandable cages, and stabilization with an anterolateral plating system designed specifically for minimally invasive implantation. This technique was performed in 5 patients with metastatic disease of the thoracic spine, including the thoracolumbar junction. Results All patients had improvement in preoperative symptoms and neurological deficits. No complications occurred in this small series. Conclusions The minimally invasive thoracoscopic approach can be applied to the treatment of thoracic and thoracolumbar metastatic spine disease in an effort to reduce access morbidity. Preliminary results have indicated that adequate decompression, reconstruction, and stabilization can be achieved with this technique.

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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.

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