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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Easy minimal invasive retractor system for the transthoracic approach – Technical Note

Meeting Abstract

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  • Eike Wilbers - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Christian Ewelt - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Nils Warneke - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Michael Schwake - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Eric José Suero Molina - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Thomas Fortmann - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Walter Stummer - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Mark Klingenhöfer - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocP148

doi: 10.3205/18dgnc489, urn:nbn:de:0183-18dgnc4890

Veröffentlicht: 18. Juni 2018

© 2018 Wilbers et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

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Objective: Anterior approaches to the thoracic spine enable corpectomy for different pathologies and vertebral replacement. However, this approach has previously required a thoracotomy incision, which is associated with significant perioperative morbidity, pain, and the potential for compromised ventilation and subsequent respiratory sequelae. The extreme lateral approach to the anterior spine has been used to treat degenerative disorders of the lower thoracic and lumbar spine, and reduces the potential complications compared with the anterior transpleural approach. We describe the first use of a new fixed, easily used retractor system for transthoracic corpectomy via a minimally invasive extreme lateral approach.

Methods: We used this new retractor system for different indications, such as pathological fractures because of osteoporosis or vertebral metastasis and spondylitis/spondylodiscitis with consecutive vertebral instability. The procedure was combined with dorsal stabilization, partly combined with cement screw augmentation.

Results: 45 patients were treated by extreme lateral transthoracic corpectomy and vertebral replacement. This new way of retractor system was easily and X-ray guided fixed into the adjacent vertebral levels via a small thoracotomy incision (4-7 cm) depending on corpectomy levels. It could be used from spinal vertebra TH 4 to L 1 from both sides without significant compromised ventilation, severe thoracic pain and with decreased morbidity.

Conclusion: This new fixed retractor system for transthoracic, extreme lateral approach to the spine is feasible and safe for degenerative discectomy or corpectomy combined with vertebral replacement by any cages. Further, even young residents less experienced in transthoracic approaches are able to perform this surgery with a tolerable learning curve.