Anterior Endoscopic Approach to the Thoracolumbar Spine

Burgos, Jesús; Rapariz, J. M.; González-Herranz, P.

doi:10.1097/00007632-199811150-00013

Cited by 31 publications

(16 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dr Newton [16] kindly forwarded to us his latest paper accepted for publication in Spine. We were therefore left with ten papers 1 [5,6,8,12,14,[16][17][18][19][20] dealing either exclusively or partially with thoracoscopic anterior release in spinal deformities and their complications. We carefully reviewed each paper in its entirety to answer our questions.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Anterior thoracoscopic spine release in deformity surgery: a meta-analysis and review

Arlet

2000

European Spine Journal

View full text Add to dashboard Cite

Videoassisted thoracoscopic surgery (VATS) allows the surgeon to perform an anterior thoracoscopic spine release for spinal deformities. It is an alternative to open thoracotomy. Several years after its introduction the present author gives an update on the indications, surgical techniques, results, and complications of this new technology. A metaanalysis of previously published papers is organized in tables in an attempt to answer all the questions and controversies that this technique has aroused. A series of ten selected articles were available for review, comprising a total of 151 procedures. No study had any long-term follow-up. Most series were pediatric and involved a variety of etiologies (mostly neuromuscular, adolescent idiopathic scoliosis, and Scheuermann's kyphosis). The surgical technique was for most authors a convex side approach in the lateral decubitus through four or more ports in the anterior or midaxillary line. Single lung ventilation was used in most cases. Posterior surgery was carried out the same day in most cases. The total number of discs excised varied between 4 and 7, but the quality of disc excision was rarely reported. Most authors carried out a spine fusion at the time of the disc release. The total VATS procedure lasted between 2 h 30 min and 4 h, depending on the series and the surgeon's previous experience. In most series curves were in the range of 55°-80°, with an average of 65°. The percentage of Cobb angle correction was 55%-63% after VATS and posterior spine fusion. For kyphotic deformities only one series had significant numbers to allow conclusions to be drawn. The mean preoperative Cobb angle was 78°and postoperatively the kyphosis was corrected to 44°. Length of hospital stay was quite similar in most series and was around 9 days. The cost of the VATS procedure was studied in one series and was found to be 28% more expensive than thoracotomy. The total complications reported were 18%; most were pulmonary complications with prolonged ventilatory support in patients with neuromuscular pathologies. The VATS procedure has been used with success in most series for pediatric curves (average Cobb angle of 65°or kyphosis of 75°). No report of the surgical outcome (balance, rate of fusion, rib hump correction, cosmetic correction, pain, and patient satisfaction) was available for any series. Further prospective study including these parameters will be required to determine the real benefit of such procedures to the patient, bearing in mind that the correction of spinal deformities is the result of the surgeon's experience, skill, and the available technology. Key words Vincent ArletAnterior thoracoscopic spine release in deformity surgery: a meta-analysis and review Received: 3 September 1999 Accepted: 6 September 1999 No support from any source was received for he completion of this study.

show abstract

Section: Methodsmentioning

confidence: 99%

“…As to the surgical endoscopic technique used to approach thoracolumbar curves as described by Burgos et al [1], we took that to be beyond the scope of this review, which deals specifically with thoracic deformities.…”

Section: Surgical Techniquementioning

confidence: 99%

Anterior thoracoscopic spine release in deformity surgery: a meta-analysis and review

Arlet

2000

European Spine Journal

View full text Add to dashboard Cite

show abstract

“…Instead of using the porcine model strictly for teaching purposes, some authors have described the use of a porcine model to test the feasibility of complex endoscopic approaches [2,19]. Rubino et al [19] used a 30°angle endoscope to view the upper thoracic and cervical spine with an entrance portal at the anterior border of the sternocleidomastoid muscle.…”

Section: Additional Uses Of a Porcine Modelmentioning

confidence: 99%

“…These authors reported excellent visualization of the entire cervical spine. Burgos et al [2] used swine to test the feasibility of a method for exposing the thoracolumbar spine. Before attempting the procedure in patients, these authors determined that in swine, the most effective method for exposure was an initial standard thoracoscopic approach followed by a retroperitoneal endoscopic approach.…”

Section: Additional Uses Of a Porcine Modelmentioning

confidence: 99%

“…because animals are readily available and inexpensive, allowing surgeons to practice in a living system before performing thoracoscopic techniques in a human patient [2,3,5,8,13,15,16,19,22]. In the porcine model, various surgical strategies can be simulated that are infeasible in a human cadaveric model, such as retracting the lung, maintaining a bloodless field during different techniques, coping with fogging of lenses, and dissecting living tissues in their physiologic conditions [7,16].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comparative anatomy of the porcine and human thoracic spines with reference to thoracoscopic surgical techniques

et al. 2005

View full text Add to dashboard Cite

show abstract

The Open Anterior Paramedian Retroperitoneal Approach for Spine Procedures

Gumbs

Shah²,

Yue³

et al. 2005

Arch Surg

View full text Add to dashboard Cite

Hypothesis: With the advent of anterior lumbar interbody fusion and artificial disk replacement as common procedures for the treatment of many spinal problems, anterior exposure has become an increasingly popular procedure for general, thoracic, urologic, and vascular surgeons. Despite this, the body of literature describing this procedure, especially the general and vascular surgery literature, is lacking. Design: A retrospective review of medical records was performed for patients operated on from April 2002 to March 2004. Setting: Tertiary care university hospital. Patients: In total, 64 open retroperitoneal exposures for anterior spinal approaches were performed. Thirty-five (55%) were performed on men and 29 (45%) on women. Interventions: Fifty patients (78%) required lumbosacral approaches, and 14 (22%) required access to purely lumbar disk spaces. Forty-three patients underwent singledisk approaches, and 21 required access to either 2 or 3 levels. Forty patients (63%) underwent anterior lumbar interbody fusion, and 22 (34%) had a Prodisc disk replacement. Main Outcome Measures: We analyzed intraoperative and early postoperative complications. Results: The average age was 43 years (range, 25-89 years), 42 and 44 years for men and women, respectively. Ninetyseven percent of all attempted retroperitoneal exposures were successful. Intraoperative complications occurred in 5 patients (8%) and included inability to mobilize the iliac veins, injury to the iliac vein, and ureteral tear. The postoperative course was complicated in 8 patients (14%) and included fever, urinary retention, spinal headache, Clostridium difficile colitis, and ileus. Conclusion: Open retroperitoneal exposure to the lumbar and lumbosacral vertebral bodies can be performed safely with a multidisciplinary approach that maximizes the various surgical skills of the orthopedic and vascular or general surgeon, reducing complication rates in anterior spinal surgery.

show abstract

Anterior Endoscopic Approach to the Thoracolumbar Spine

Abstract: The anterior endoscopic approach to the lumbar spine involves minor trauma, results in rapid recovery and less pain, and produces good results aesthetically.

Cited by 31 publications

References 10 publications

Anterior thoracoscopic spine release in deformity surgery: a meta-analysis and review

Anterior thoracoscopic spine release in deformity surgery: a meta-analysis and review

Comparative anatomy of the porcine and human thoracic spines with reference to thoracoscopic surgical techniques

The Open Anterior Paramedian Retroperitoneal Approach for Spine Procedures

Contact Info

Product

Resources

About