Abstract
A retrospective analysis of patients with thoracolumbar junction fractures who underwent video-assisted thoracoscopic surgery via a minimally invasive approach (minithoracotomy) for reconstruction of the anterior spinal column. Between 2002 and 2014, a total of 176 patients were treated by this technique. The patients received either posterior stabilization and, at the second stage, the minimally invasive technique via an anterior approach, or the minimally invasive anterior procedure alone. In the anterior procedure, the average operative time was 90 min. (50 to 130 min). Bony fusion without complications was achieved in all patients within a year of surgery. The loss of correction after the anterior procedure with an allograft or titanium cage was up to 2 degrees at two years follow-up. The minimally invasive approach (minithoracotomy up to 6-7 cm) combined with thoracoscopy is an alternative to an exclusively endoscopic technique enabling us to provide safe surgical treatment of the anterior spinal column.
Highlights
The anterior approach to the thoracolumbar junction of the spine was first described by Hodgson in 1960
Two thirds of injuries to the thoracic and lumbar spine are located in the region of the Th/L junction
The result is a fracture of a different grade of kyphosis due to destruction of the anterior column and injury to the bony or ligamentous posterior structures with a compression of the spinal canal[8]
Summary
The anterior approach to the thoracolumbar junction of the spine was first described by Hodgson in 1960 (ref.[1]). This extensive approach to the Th/L junction provided excellent exposure of the surgical site but was associated with a significant morbidity of the thoracic and abdominal walls[2]. It was reserved for patients with a marked posttraumatic deformity or a structural disease of the spine requiring reconstruction of the anterior column of the spine. We reconstructed the anterior column of the spine by mini-thoracotomy in combination with thoracoscopy
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Schedule a callMore From: Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
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