Traumatic thoracolumbar spinal injury: an algorithm for minimally invasive surgical management

2014 ◽  
Vol 37 (1) ◽  
pp. E9 ◽  
Author(s):  
Sanjay S. Dhall ◽  
Rishi Wadhwa ◽  
Michael Y. Wang ◽  
Alexandra Tien-Smith ◽  
Praveen V. Mummaneni
Keyword(s):  
Minimally Invasive ◽  
Spinal Injury ◽  
Treatment Algorithm ◽  
Trauma Treatment ◽  
Posterior Decompression ◽  
The Past ◽  
Minimally Invasive Surgical ◽  
Thoracolumbar Injury ◽  
Mini Open

Object Minimally invasive spinal (MIS) surgery techniques have been used sporadically in thoracolumbar junction trauma cases in the past 5 years. A review of the literature on the treatment of thoracolumbar trauma treated with MIS surgery revealed no unifying algorithm to assist with treatment planning. Therefore, the authors formulated a treatment algorithm. Methods The authors reviewed the current literature on MIS treatment of thoracolumbar trauma. Based on the literature review, they then created an algorithm for the treatment of thoracolumbar trauma utilizing MIS techniques. This MIS trauma treatment algorithm incorporates concepts form the Thoracolumbar Injury Classification System (TLICS). Results The authors provide representative cases of patients with thoracolumbar trauma who underwent MIS surgery utilizing the MIS trauma treatment algorithm. The cases involve the use of mini-open lateral approaches and/or minimally invasive posterior decompression with or without fusion. Conclusions Cases involving thoracolumbar trauma can safely be treated with MIS surgery in select cases of burst fractures. The role of percutaneous nonfusion techniques remains very limited (primarily to treat thoracolumbar trauma in patients with a propensity for autofusion [for example, those with ankylosing spondylitis]).

Current Options for the Treatment of Pectus Carinatum: When to Brace and When to Operate?

2018 ◽  
Vol 28 (04) ◽  
pp. 347-354 ◽  
Author(s):  
Sherif Emil
Keyword(s):  
Minimally Invasive ◽  
Chest Wall ◽  
Pectus Excavatum ◽  
Surgical Correction ◽  
Diagnosis And Treatment ◽  
Pectus Carinatum ◽  
The Past ◽  
Minimally Invasive Surgical

AbstractPectus carinatum has traditionally been described as a rare chest wall anomaly in comparison to pectus excavatum. However, recent data from chest wall anomaly clinics demonstrate that this deformity is probably much more frequent than once believed. In the past, invasive surgical correction by the Ravitch technique was essentially the only option for treatment of pectus carinatum. Major advances over the past two decades have provided additional options, including noninvasive chest wall bracing and minimally invasive surgical correction. This article will discuss current options for the treatment of pectus carinatum, and some of the factors that should be taken into account when choosing the options available. Diagnosis and treatment of the pectus arcuatum variant will also be described.

scholarly journals Bilateral tubular minimally invasive approach for decompression, reduction and fixation in lumbosacral lythic spondylolisthesis

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video9 ◽  
Author(s):  
Giuseppe M.V. Barbagallo ◽  
Francesco Certo ◽  
Giovanni Sciacca ◽  
Vincenzo Albanese
Keyword(s):  
Minimally Invasive ◽  
Postoperative Recovery ◽  
Pedicle Screw Fixation ◽  
Invasive Technique ◽  
Surgical Morbidity ◽  
Nerve Roots ◽  
Invasive Approach ◽  
Minimally Invasive Surgical ◽  
Pull Out ◽  
Mini Open

This video demonstrates the minimally invasive surgical technique used in a 56-year-old woman suffering from L-5 spondylolysis and grade 2 L5–S1 spondylolisthesis. The first author used expandable tubular retractors bilaterally to perform neural decompression, mini-open TLIF, spondylolysthesis reduction and L5–S1 pedicle screw fixation. L-5 cement augmentation was performed through cannulated and fenestrated screws to enhance resistance to screw pull-out secondary to reduction maneuvers.Sequential surgical steps related to microsurgery, spondylolysthesis reduction and instrumentation are shown and commented.We submit that in cases of lythic spondylolisthesis a bilateral traversing and exiting nerve roots decompression is a safer option prior to performing the deformity reduction and fixation; the proposed minimally invasive technique may help in reducing surgical morbidity and improving postoperative recovery.The video can be found here: http://youtu.be/G4Qdg-A-Y3M.

Carpal tunnel syndrome: matching minimally invasive surgical techniques

2008 ◽  
Vol 108 (5) ◽  
pp. 1033-1036 ◽  
Author(s):  
Vittoria Nazzi ◽  
Angelo Franzini ◽  
Giuseppe Messina ◽  
Giovanni Broggi
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Minimally Invasive ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Surgical Techniques ◽  
The Past ◽  
Minimally Invasive Surgical ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B

✓In the past few years, several different minimally invasive surgical techniques have been proposed to decompress the median nerve at the wrist. Use of these techniques has become widespread due to fewer local complications, faster functional recovery, and reduced surgical time. In this paper the authors compare 3 different minimally invasive surgical techniques used at their institution in the past 13 years. Between January 1994 and January 2007, 891 patients underwent 1272 surgeries at the authors' institution for carpal tunnel syndrome (CTS), for which a minimally invasive technique was used. In 473 cases (Group A), the transillumination technique with a single wrist incision and a “carpalotome” (a modified Paine retinaculotome) was used; in 216 cases (Group B), transillumination was abandoned and a single linear wrist incision for access with the carpalotome was performed; and in 583 cases (Group C), the techniques were further modified by making a second incision in the palm using the carpalotome. All 3 groups of patients were homogeneous for age, sex, and duration of the symptomatology. In 90% of the patients in Group A, in 88% of those in Group B, and 99.8% of patients in Group C, complete remission of symptoms was obtained. Due to persistence of symptoms, 44 patients in Group A, 24 in Group B, and only 1 in Group C underwent a repeated operation with the open technique. The only surgical complication requiring repeated operation of the 1272 operations was a lesion of the primitive median artery (1 patient in Group C). The technique of median nerve decompression at the wrist that was used for patients in Group C represents a valid alternative for treatment of CTS.

scholarly journals Minimally Invasive Approaches in the Thoracic Surgery

2021 ◽  
Author(s):  
Güntuğ Batıhan ◽  
Kenan Can Ceylan
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Thoracic Surgery ◽  
Invasive Surgery ◽  
Minimally Invasive Techniques ◽  
The Past ◽  
Minimally Invasive Surgical ◽  
First Choice ◽  
Surgical Methods ◽  
Invasive Techniques

Minimally invasive techniques in thoracic surgery have made great progress over the past 20 years and are still evolving. Many surgical procedures performed with large thoracotomy incisions in the past can now be performed with much smaller incisions. With many studies, the advantages of minimally invasive surgery have been clearly seen, and thus its use has become widespread worldwide. Today, minimally invasive surgical methods have become the first choice in the diagnosis and treatment of lung, pleural and mediastinal pathologies. Minimally invasive approaches in thoracic surgery include many different techniques and applications. In this chapter, current minimally invasive techniques in thoracic surgery are discussed and important points are emphasized in the light of the current literature.

scholarly journals Mini-open removal of intradural spinal tumor

2012 ◽  
Vol 33 (Suppl1) ◽  
pp. 1 ◽  
Author(s):  
Jason S. Cheng ◽  
Cheerag Upadhyaya ◽  
Jau-Ching Wu ◽  
Tsung-Hsi Tu ◽  
Praveen V. Mummaneni
Keyword(s):  
Minimally Invasive ◽  
Spinous Process ◽  
Case Series ◽  
Spinal Tumor ◽  
Tubular Retractor ◽  
Minimally Invasive Surgical ◽  
Post Operative Pain ◽  
Spinal Segments ◽  
Key Steps ◽  
Mini Open

Minimally invasive surgical (MIS) approaches have gained popularity in many surgical fields. Potential advantages to a minimally invasive, spinal intradural approach include decreased operative blood loss, shorter hospitalization, and less post-operative pain. Potential disadvantages include longer operative times, decreased exposure, and difficulty closing the dura. Prior case series from our group and others have demonstrated successful tumor resections using MIS techniques without increased complications. In this 3D video, we demonstrate the key steps in our mini-open, transpinous approach for the resection of an intradural, extramedullary lumbar schwannoma. This operation is performed through a midline incision confined to one or two levels. The spinous process is removed. The paraspinal muscles are spread using a series of sequentially larger tubular dilators, and the first dilator is placed in the space previously occupied by the target level spinous process. The expandable tube retractor is then placed over the largest dilator and docked into place over the target laminae. The expandable tubular retractor is 6 centimeters in depth and 2.5 centimeters in width before expansion and is adjustable to 9 centimeters in depth and 4–5 centimeters in diameter which allows removal of intradural lesions confined to one or two spinal segments. The video can be found here: http://youtu.be/l_C4VruKYng.

scholarly journals Intratympanic corticosteroid perfusion in the therapy of Meniere’s disease

2014 ◽  
Vol 142 (5-6) ◽  
pp. 291-295 ◽  
Author(s):  
Snezana Sankovic-Babic ◽  
Rade Kosanovic ◽  
Zoran Ivankovic ◽  
Snezana Babac ◽  
Milica Tatovic
Keyword(s):  
Minimally Invasive ◽  
Action Potentials ◽  
Therapeutic Option ◽  
Experimental Studies ◽  
Hearing Threshold ◽  
Minimally Invasive Surgical ◽  
Hearing Function ◽  
One Year

Introduction. Over the last two decades the intratympanic perfusion of corticosteroids has been used as a minimally invasive surgical therapy of Meniere?s disease. According to experimental studies the antiinflammatory, immunoprotective, antioxidant and neuroprotective role of the locally perfused corticosteroids was noticed in the inner ear structures. The recovery of action potentials in the cells of the Corti organ was confirmed as well as a decreased expression of aquaporine-1, a glycoprotein responsible for labyrinth hydrops and N and K ions derangement. Objective. The study showed results of intratympanic perfusion therapy with dexamethasone in patients with retractable Meniere?s disease who are resistant to conservative treatment. Methods. Single doses of 4 mg/ml dexamethasone were given intratympanically in 19 patients with retractable Meniere?s disease. Six single successive doses of dexamethasone were administered in the posteroinferior quadrant of the tympanic membrane. Follow-up of the patients was conducted by using a clinical questionnaire a month after completed perfusion series as well as on every third month up to one year. Results. One month after completed first course of perfusions, in 78% of patients, vertigo problems completely ceased or were markedly reduced. The recovery of hearing function was recorded in 68% and marked tinnitus reduction in 84% of patients. After a year of follow-up, in 63% of patients the reduction of vertigo persisted, while hearing function was satisfactory in 52%. Tinitus reduction was present in 73% of patients. Conclusion. Intratympanic perfusion of dexamethasone in patients with Meniere?s disease is a minimally invasive therapeutic method that contributes to the reduction of the intensity of vertigo recurrent attacks, decrease of the intensity of tinnitus and improvement of the average hearing threshold. Patients with chronic diseases and Meniere?s disease who are contraindicted for systemic administration of cortocosteroids (hypertension, diabetes, glaucoma, peptic ulcer, etc.) have an additional therapeutic option by dexamethasone intratympanic perfusion.

scholarly journals Minimally invasive surgical management of gastric malignancies: role of robotic surgery

2021 ◽  
Vol 0 ◽  
pp. 0-0
Author(s):  
Carolina Vanetta ◽  
Michael Lidsky ◽  
Garth S. Herbert ◽  
Kevin N. Shah ◽  
Sabino Zani
Keyword(s):  
Robotic Surgery ◽  
Minimally Invasive ◽  
Surgical Management ◽  
Minimally Invasive Surgical
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