Anterior Thoracic Surgical Approaches in the Treatment of Spinal Infections and Neoplasms

Schuchert, Matthew J.; McCormick, Kristen N.; Abbas, Ghulam; Pennathur, Arjun; Landreneau, Joshua P.; Landreneau, James R.; Pitanga, Andre; Gomes, Jamilly; França, F.G.O.; El-Kadi, Matthew; Peitzman, Andrew B.; Ferson, Peter F.; Luketich, James D.; Landreneau, Rodney J.

doi:10.1016/j.athoracsur.2013.09.085

Cited by 21 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…28 (45.9%) of the MISS patients were treated for spinal instability alone and 33 (54.1%) were treated for MSCC, while in the OSS group, only 15 (10.8%) were treated for spinal instability alone and the rest 124 (89.2%) for MSCC (P < .001) (Table 1). The median SINS in our study was 13 (10)(11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Demographic Datamentioning

confidence: 54%

“…While anterior approaches may be effective in achieving ventral decompression, they are associated with significant approach related morbidity. 16 In recent years, the transpedicular approach as described by Bilsky et al 17 has increased in popularity as circumferential decompression can be achieved via a posterior approach without the morbidity of an anterior approach. Minimal access approaches have been described to perform both separation surgery and anterior reconstruction.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Utility of ‘Minimal Access and Separation Surgery’ in the Management of Metastatic Spine Disease

Kumar

Tan

Thomas

et al. 2022

Global Spine Journal

View full text Add to dashboard Cite

Study Design Retrospective cohort study. Objectives To compare outcomes of percutaneous pedicle screw fixation (PPSF) to open posterior stabilization (OPS) in spinal instability patients and minimal access separation surgery (MASS) to open posterior stabilization and decompression (OPSD) in metastatic spinal cord compression (MSCC) patients. Methods We analysed patients who underwent surgery for thoracolumbar metastatic spine disease (MSD) from Jan 2011 to Oct 2017. Patients were divided into minimally invasive spine surgery (MISS) and open spine surgery (OSS) groups. Spinal instability patients were treated with PPSF/OPS with pedicle screws. MSCC patients were treated with MASS/OPSD. Outcomes measured included intraoperative blood loss, operative time, duration of hospital stay and ASIA-score improvement. Time to initiate radiotherapy and perioperative surgical/non-surgical complications was recorded. Propensity scoring adjustment analysis was utilised to address heterogenicity of histological tumour subtypes. Results Of 200 eligible patients, 61 underwent MISS and 139 underwent OSS for MSD. There was no significant difference in baseline characteristics between MISS and OSS groups. In the MISS group, 28 (45.9%) patients were treated for spinal instability and 33 (54.1%) patients were treated for MSCC. In the OSS group, 15 (10.8%) patients were treated for spinal instability alone and 124 (89.2%) were treated for MSCC. Patients who underwent PPSF had significantly lower blood loss (95 mL vs 564 mL; P < .001) and surgical complication rates( P < .05) with shorter length of stay approaching significance (6 vs 19 days; P = .100) when compared to the OPS group. Patients who underwent MASS had significantly lower blood loss (602 mL vs 1008 mL) and shorter length of stay (10 vs 18 days; P = .098) vs the OPSD group. Conclusion This study demonstrates the benefits of PPSF and MASS over OPS and OPSD for the treatment of MSD with spinal instability and MSCC, respectively.

show abstract

Section: Demographic Datamentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

The Utility of ‘Minimal Access and Separation Surgery’ in the Management of Metastatic Spine Disease

Kumar

Tan

Thomas

et al. 2022

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…Our own institutional experience of having thoracic surgeons perform thoracotomy for exposure to assist spine surgeons in replacing compression fractured vertebrae with spinal cages allowed 2 siloed specialties to cross-pollinate ideas. This led to our own development of a 2-incision technique for tumors invading T2-T4 levels, which closely mirrors but also deviates in key ways from previous reports in the literature [14].…”

Section: Commentmentioning

confidence: 69%

Early Surgical Outcomes of En Bloc Resection Requiring Vertebrectomy for Malignancy Invading the Thoracic Spine

Mody

Iñiguez

Armstrong

et al. 2016

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…The anterior approach helps to avoid injury to the spinal dura mater, surgical site infection, pulmonary infection, anterior cord syndrome and many others possible lesions. 7,12 There are reports of uncommon injuries to consider, such as the chain of sympathetic ganglia that are most frequently found anterior and at the level of the costal heads, with special attention to the Kuntz nerves at the level of T2 and T3, 13 even more rarely, massive cerebral ischemia due to carotid artery traction has been reported during the placement of retractors in an anterior mediastinal approach. 14 For this, surgical planning methods have been implemented to help deciding which approach is sufficient in the visualization of the anterior levels, as well as to assess the need to perform a posterior combined approach to achieve adequate stability and a lower rate of failures in the instrumentation and minimize risk.…”

Section: Discussionmentioning

confidence: 99%

Abordaje torácico anterior infraclavicular para el acceso a las vértebras torácicas superiores: reporte de un caso y descripción de una nueva técnica quirúrgica

Rodríguez-Munera,

Marroquín-Herrera,

Hakim-Daccach

et al. 2023

Acta Ortopédica Mexicana

View full text Add to dashboard Cite

Patient with spondylodiscitis who presented kyphosis deformity with neurological compromise at the upper thoracic level, who was treated with a new right infraclavicular anterior thoracic approach, as a new alternative surgical technique. 72-year-old male with kyphosis deformity secondary to T2-T3 ASIA «C» spondylodiscitis, treated with C5 to T6 posterior cervicothoracic instrumentation and right infraclavicular transthoracic anterior approach utilizing an expandable cylinder. Within the literature review carried out in the search engines, no similar techniques to the one described in this article were found. Given the complexity of the surgical approach, this new technique is described as a new way for accessing the upper thoracic spine, demonstrating that the right infraclavicular anterior thoracic approach is a new alternative to access the upper thoracic spine from T1 to T4.

show abstract

Anterior Thoracic Surgical Approaches in the Treatment of Spinal Infections and Neoplasms

Cited by 21 publications

References 19 publications

The Utility of ‘Minimal Access and Separation Surgery’ in the Management of Metastatic Spine Disease

The Utility of ‘Minimal Access and Separation Surgery’ in the Management of Metastatic Spine Disease

Early Surgical Outcomes of En Bloc Resection Requiring Vertebrectomy for Malignancy Invading the Thoracic Spine

Abordaje torácico anterior infraclavicular para el acceso a las vértebras torácicas superiores: reporte de un caso y descripción de una nueva técnica quirúrgica

Contact Info

Product

Resources

About