Minimally invasive thoracic decompression for multi-level thoracic pathologies

Abstract

We describe our experience using a minimal access approach for multi-level dorsal decompression of the thoracic spine that may limit approach-related soft-tissue injury and spinal destabilization. Additionally, three patients, each with unique compressive thoracic pathology, are discussed. A single minimal access technique, using multi-level hemilaminotomies, was used to address these unique pathologies via a similar approach. The three patients in this study had a mean age of 49.3years (range: 45–55years), mean estimated blood loss of 750cc (range: 350–1000cc), mean operative time of 3.8hours (range: 3–5hours), and a mean post-operative hospital stay of 2.3days (range: 2–3days). Complete decompression was achieved with resolution of symptoms in all patients. Long-term follow-up averaged 26.7months (range: 15–36months). Radiographic decompression was demonstrated in all patients. Minimal access techniques using muscle-splitting tubular retractor systems can effectively treat multi-level dorsal compression of the thoracic cord, while potentially limiting morbidity and long-term spinal instability.