Minimally invasive corpectomy and percutaneous transpedicular stabilization in the treatment of patients with unstable injures of the thoracolumbar spine: Results of retrospective case series

Study Design: Retrospective case series. Objective: To report our experience with corpectomy of the thoracolumbar (TL) spine through a minimally invasive lateral retropleural or retroperitoneal approach. Methods: This is a retrospective case series of 20 consecutive patients who underwent minimally invasive TL corpectomy and spinal reconstruction. Electronic medical records were reviewed for demographic, operative, and clinical outcome data. Results: Between 2015 and 2019, 20 consecutive cases of minimally invasive TL corpectomy were performed, comprising 12 men (60%) and 8 women (40%) with a mean age of 54.3 years. Indications for surgery were infection (n = 6, 30%), metastatic disease (n = 2, 10%), fracture (n = 6, 30%), and calcified disc herniation (n = 6, 30%). Partial and complete corpectomy was performed in 5 patients (25%) and 15 patients (75%), respectively. Mean operative time and estimated blood loss was 276.2 minutes and 558.4 mL, respectively. Mean length of stay from admission and surgery were 14.6 and 11.4 days, respectively. Mean length of stay from surgery for elective cases was 4.2 days. Mean follow-up time was 330.4 days. Visual analogue scale score improved from 7.7 to 4.5 ( P < .01). There were a total of 3 postoperative complications in 2 patients, including 1 mortality for urosepsis. One patient had revision spinal surgery for adjacent segment disease. Conclusions: Corpectomy and reconstruction of the TL spine is feasible and safe using a minimally invasive lateral retropleural or retroperitoneal approach. Since this is a relatively new technique, more studies are needed to compare the short- and long-term radiographic and clinical outcomes between minimally invasive versus open corpectomy of the TL spine.

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Answer to the Letter to Editor of S. Kumar et al. concerning “Safety and effectiveness of minimally invasive scoliosis surgery for adolescent idiopathic scoliosis: a retrospective case series of 84 patients” by Yang JH, et al. (Eur Spine J [2020]; 29: 761–769)

European Spine Journal ◽

10.1007/s00586-021-06846-9 ◽

2021 ◽

Author(s):

Dong-Gune Chang ◽

Seung Woo Suh

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Minimally Invasive ◽

Idiopathic Scoliosis ◽

Case Series ◽

Scoliosis Surgery ◽

Retrospective Case ◽

Retrospective Case Series

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Minimally invasive distal metaphyseal metatarsal osteotomy (DMMO) for symptomatic forefoot pathology – Short to medium term outcomes from a retrospective case series

The Foot ◽

10.1016/j.foot.2018.12.003 ◽

2019 ◽

Vol 38 ◽

pp. 43-49 ◽

Cited By ~ 3

Author(s):

Karan Malhotra ◽

Nikita Joji ◽

Simon Mordecai ◽

Ben Rudge

Keyword(s):

Minimally Invasive ◽

Case Series ◽

Metatarsal Osteotomy ◽

Medium Term ◽

Retrospective Case ◽

Retrospective Case Series

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Management of gastric conduit retention following hybrid and minimally invasive esophagectomy for esophageal cancer: Two retrospective case series

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2017.11.040 ◽

2017 ◽

Vol 41 ◽

pp. 505-510 ◽

Cited By ~ 2

Author(s):

Ingvild Farnes ◽

Egil Johnson ◽

Hans-Olaf Johannessen

Keyword(s):

Esophageal Cancer ◽

Minimally Invasive ◽

Minimally Invasive Esophagectomy ◽

Case Series ◽

Gastric Conduit ◽

Retrospective Case ◽

Invasive Esophagectomy ◽

Retrospective Case Series

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Use of the SpineJack direct reduction for treating type A2, A3 and A4 fractures of the thoracolumbar spine: a retrospective case series

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2021-017682 ◽

2021 ◽

pp. neurintsurg-2021-017682

Author(s):

Giorgio Lofrese ◽

Luca Ricciardi ◽

Pasquale De Bonis ◽

Francesco Cultrera ◽

Michele Cappuccio ◽

...

Keyword(s):

Minimally Invasive ◽

Direct Reduction ◽

Thoracolumbar Spine ◽

Case Series ◽

Osteoporotic Fractures ◽

Neurological Impairment ◽

Radiological Outcome ◽

Retrospective Case ◽

Younger Patients ◽

Kyphosis Correction

BackgroundCompression injuries of the thoracolumbar spine without neurological impairment are usually treated with minimally invasive procedures. Intravertebral expandable implants represent an alternative strategy in fractures with low fragments’ displacement.MethodsPatients with A2, A3 and A4 fractures of the T10–L2 spinal segment without neurological impairment, fracture gap >2 mm, vertebra plana, pedicle rupture, pedicle diameter <6 mm, spinal canal encroachment ≥50%, and vertebral body spread >30% were treated with the SpineJack device. Patients with pathological/osteoporotic fractures were excluded. Demographic and fracture-related data were assessed together with vertebral kyphosis correction, vertebral height restoration/loss of correction and final kyphosis. The modified Rankin Scale (mRS), Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), Smiley–Webster Pain Scale (SWPS) and EuroQol-5D (EQ-5D) were evaluated at 1 (-post), 6 and 12 months (-fup) after surgery. Statistical analysis was performed and p values ≤0.05 were considered significant.ResultsFifty-seven patients were included in the study. Patients aged >60 years reported worse kyphosis correction (<4°) with more postoperative complications, while vertebral plasticity in younger patients, fragmentation-related greater remodeling in A3/A4 fractures, and treatments within 7 days of trauma determined superior wedging corrections, with better EQ-5D-post and mRS-fup. Cement leakages did not affect functional outcome, while female gender and American Society of Anesthesiologists (ASA) score of 3–4 were associated with worse ODI-fup and VAS-fup. Although fracture characteristics and radiological outcome did not negatively influence the clinical outcome, A2 fracture was a risk factor for complications, thus indirectly compromising both the functional and radiological outcome.ConclusionWith spread of <30%, the SpineJack is an alternative to minimally invasive fixations for treating A3/A4 thoracolumbar fractures, being able to preserve healthy motion segments in younger patients and provide an ultra-conservative procedure for elderly and fragile patients.

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Effect of Mini-invasive Floating Metatarsal Osteotomy on Plantar Pressure in Patients With Diabetic Plantar Metatarsal Head Ulcers

Foot & Ankle International ◽

10.1177/1071100720976099 ◽

2020 ◽

pp. 107110072097609

Author(s):

Eran Tamir ◽

Michael Tamar ◽

Moshe Ayalon ◽

Shlomit Koren ◽

Noam Shohat ◽

...

Keyword(s):

Minimally Invasive ◽

Plantar Pressure ◽

Case Series ◽

Metatarsal Head ◽

Metatarsal Osteotomy ◽

Retrospective Case ◽

Level Of Evidence ◽

Retrospective Case Series ◽

Pressure Time ◽

Peak Plantar Pressure

Background: Distal metatarsal osteotomy has been used to alleviate plantar pressure caused by anatomic deformities. This study’s purpose was to examine the effect of minimally invasive floating metatarsal osteotomy on plantar pressure in patients with diabetic metatarsal head ulcers. Methods: We performed a retrospective case series of prospectively collected data on 32 patients with diabetes complicated by plantar metatarsal head ulcers without ischemia. Peak plantar pressure and pressure time integrals were examined using the Tekscan MatScan prior to surgery and 6 months following minimally invasive floating metatarsal osteotomy. Patients were followed for complications for at least 1 year. Results: Peak plantar pressure at the level of the osteotomized metatarsal head decreased from 338.1 to 225.4 kPa ( P < .0001). The pressure time integral decreased from 82.4 to 65.0 kPa·s ( P < .0001). All ulcers healed within a mean of 3.7 ± 4.2 weeks. There was 1 recurrence (under a hypertrophic callus of the osteotomy) during a median follow-up of 18.3 months (range, 12.2-27). Following surgery, adjacent sites showed increased plantar pressure and 4 patients developed transfer lesions (under an adjacent metatarsal head); all were managed successfully. There was 1 serious adverse event related to surgery (operative site infection) that resolved with antibiotics. Conclusion: This study showed that the minimally invasive floating metatarsal osteotomy successfully reduced local plantar pressure and that the method was safe and effective, both in treatment and prevention of recurrence. Level of Evidence: Level III, retrospective case series of prospectively collected data.

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