Article
Minimally invasive lateral thoracotomy for microscopically assisted anterior reconstruction of the thoracic and thoracolumbar spine
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Authors
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Jan Walter
- Department of Neurosurgery, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
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Christian Ewald
- Department of Neurosurgery, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
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Rolf Kalff
- Department of Neurosurgery, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
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Albrecht Waschke
- Department of Neurosurgery, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
| Published: | June 2, 2015 |
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Outline
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Objective: Video-assisted thoracoscopic approaches to the anterior thoracic spine were introduced during the past years, reducing access morbidity, blood loss, reduction of hospital stay and decrease of post-thoracotomy pain syndromes. Those obvious advantages have to be weighed against a long learning curve, longer operation times, and financial investments. Hence we were interested, if a minimal invasive, microscopically assisted open access to the anterior thoracic and thoracolumbar spine could combine the advantages of endoscopic approaches with the ones of classical open procedures.
Method: Prospective feasibility and outcome analysis of minimally invasive lateral thoracotomy for microscopically assisted reconstruction of the anterior thoracic and thoracolumbar spine in comparison to open, non-minimal invasive techniques.
Results: 58 consecutive patients were operated from 06/2012 to 06/2014 for spinal pathologies on the thoracic (T4-12) and lumbar (L1-L2) spine via a mini-open lateral thoracotomy, followed by a microscopically assisted reconstruction of the anterior column. This cohort was compared to retrospectively collected data of 46 patients, operated for the same indications using classical open, non-minimally invasive procedures. There was no significant difference the average operating time and mean blood loss between both groups. Patients operated with the mini-open, microscopically assisted procedure benefitted from reduced access morbidity with shortened hospital stay, and reduced post-thoracotomy pain syndromes.
Conclusions: Microscopically assisted mini-open thoracotomy combines the advantage of binocular vision and handling with minimal invasiveness being comparable to endoscopic approaches. The technique obviates long learning curves as well as investments in endoscopic set-ups.
