gms | German Medical Science

Objective: The aim of the study was to review the intraoperative findings and early post-op results of mini-thoracotomy versus endoscopic surgery of patients with non-neoplastic thoracic spine diseases.

Methods: Between 1999 and 2009, 131 patients with non-neoplastic (injury, spondylodiscitis and degenerative diseases) thoracic spine diseases were treated by endoscopic or open (mini-thoracotomy) approaches. The data were extracted from the charts of the patients and analysed retrospectively.

Results: Out of 131 patients (mean age 48 years, female 29%), 87 (66%) were treated by endoscopic and 44 (34%) by open approach. 63% had injuries, 20% spondylodiscitis and 17% degenerative thoracic spine diseases. The most frequent localization of all pathologies was Th12 (endoscopic surgery n=27, open surgery n=18). The mean operation time was 160 minutes (endoscopic 157 min, open 182 min, p<0.041), the mean blood loss was 700 ml (endoscopic 700 ml, open 750 ml, p<0.409). The mean postoperative in hospital stay was 10 days (endoscopic 9 days, open 12 days, p < 0.030). The average duration of post-op opioid analgesics intake was 5 days (endoscopic 5 days, open 6 days, p<0.186). The overall complication rate was 18% (endoscopic 23%, open 16%, p<0.062), while the vast majority of the complications were reversible. There was no perioperative mortality.

Conclusions: Taken all together, both approaches (endoscopic and open) are comparable regarding intraoperative results and early clinical outcome. Duration of surgery and post-op in hospital stay may be minimally shorter and complication rates may be minimally higher in endoscopic than in open surgery. These findings have to be confirmed by prospective studies.