Minimally invasive thoracolumbar corpectomy with navigated expandable vertebral cage: A technical note

Tanaka, Masato; Fujiwara, Yoshihiro; Uotani, Koji; Ayhan, Selim; Yamauchi, Taro; Sonawane, Sumeet; Nakanishi, Kazuo

doi:10.1016/j.inat.2021.101123

Cited by 6 publications

(15 citation statements)

References 22 publications

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“…Major operations in elderly populations have higher complication rates [ 1 ], so efforts to minimize surgical approaches without compromising the treatment objectives have been explored. Several options are available to reconstruct collapsed vertebrae, such as autogenous iliac crest bone graft, allograft, non-expandable cage [ 13 ], and expandable vertebral cage [ 4 ]. For severely osteoporotic patients, autogenous iliac bone graft is inadequate, because the bone quality is insufficient to maintain stability.…”

Section: Discussionmentioning

confidence: 99%

“…The minimally invasive retroperitoneal approach for interbody fusion is well documented, but only sporadic reports of a similar approach for the more extensive procedure of corpectomy have been published [ 4 , 19 , 21 ]. Navigation makes corpectomy feasible through a small portal in particular, which is difficult to do at the L5 level as in the present case.…”

Section: Discussionmentioning

confidence: 99%

“…Accurate cage placement can be difficult between lordotic endplates after corpectomy [ 2 ]. Intraoperative fluoroscopy alone is unable to clearly show the correct three-dimensional position of the cage [ 4 , 21 ]. Yu et al [ 21 ] reported the use of O-arm navigation for thoracolumbar corpectomy, but the cage in that case was not navigated.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, L5 corpectomy has been considered to have a high complication rate [ 3 ]. The problem with major surgeries such as corpectomy and long posterior corrective fusion in elderly patients is the high rate of complications [ 4 ]. Therefore, minimally invasive surgery (MIS) has been receiving increasing attention as a method of reducing morbidity and perioperative complications for spinal surgery [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Computer-assisted spinal surgery is the current trend for spinal surgeries, and three-dimensional image guidance technology is available for spinal MIS [ 7 ]. Another concern for MIS surgeons is radiation exposure when performing MIS under C-arm guidance [ 4 ]. Considering the above issues, we report a new technique for MIS L5 corpectomy with a navigated expandable cage under navigation guidance.…”

Section: Introductionmentioning

confidence: 99%

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Minimally Invasive L5 Corpectomy with Navigated Expandable Vertebral Cage: A Technical Note

et al. 2021

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Background: Conventional L5 corpectomy requires a large incision and an extended period of intraoperative fluoroscopy. We describe herein a new L5 corpectomy technique. Methods: A 79-year-old woman was referred to our hospital for leg pain and lower back pain due to an L5 vertebral fracture. Her daily life had been affected by severe lower back pain and sciatica for more than 2 months. We initially performed simple decompression surgery, but this proved effective for only 10 months. Results: For revision surgery, the patient underwent minimally invasive L5 corpectomy with a navigated expandable cage without fluoroscopy. The second surgery took 215 min, and estimated blood loss was 750 milliliters. The revision surgery proved successful, and the patient could then walk using a cane. In terms of clinical outcomes, the Oswestry Disability Index improved from 66% to 24%, and the visual analog scale score for lower back pain improved from 84 to 31 mm at the 1-year follow-up. Conclusions: Minimally invasive L5 corpectomy with a navigated expandable vertebral cage is effective for reducing cage misplacement and surgical invasiveness. With this new technique, surgeons and operating room staff can avoid the risk of adverse events due to intraoperative radiation exposure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%