Surgical approaches to L5 corpectomy: a systematic review

D’Aquino, Daniel; Tarawneh, Ahmad M.; Hilis, Aaron; Palliyil, Nigil Sadanandan; Deogaonkar, Kedar; Quraishi, Nasir A.

doi:10.1007/s00586-020-06617-y

Cited by 5 publications

(13 citation statements)

References 7 publications

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“…However, aggressive surgical interventions are required in patients with neurological deficits and severe deformities, with the goal of neurological decompression and correction of the deformity [ 12 ]. 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 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our case demonstrated a novel minimally invasive simultaneous technique of L5 corpectomy with a navigated expandable cage and posterior percutaneous pedicle screw fixation using O-arm navigation. Surgical approaches to pathology of the L5 vertebra constitute a significant challenge due to the anatomical features of the lumbosacral junction [ 1 ]. The biomechanics of this area are characterized by high shearing force and compressive forces [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hiyama et al, reported an additional average repositioning time of 34 min between the lateral decubitus and prone positions [18]. Single-position surgery reduces the time and need for staffing associated with intraoperative repositioning and may provide significant cost savings [1]. Percutaneous posterior pedicle screw fixation in the lateral position per se can be technically challenging, but the use of navigation makes it feasible and accurate [4,19].…”

Section: Discussionmentioning

confidence: 99%

“…Thoracolumbar junction shows several features compared with other spine areas. Surgical approaches to pathologies involving the L5 vertebra constitute a significant challenge due to its anatomical features [ 1 ]. The biomechanics of this area are characterized by a high shearing force and compressive forces [ 2 ].…”

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%

Section: Discussionmentioning

confidence: 99%

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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“…The surgical approach for pathologies of the L5 vertebra is recognized for being one of the most challenging surgical scenarios for any spine surgeon [ 15 , 20 ]. The anatomical features of the lumbosacral junction employ high-level stress on surgical constructs; sliding and compressive forces are key factors that contribute to this challenging procedure [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Multilevel L4 and L5 Corpectomy for Burst Fracture via an Anterior Transperitoneal Approach Followed by Posterior Stabilization: Technical and Anatomic Considerations

Gassie

Erben

Fortich

et al. 2021

Cureus

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Lower lumbar spine burst fractures make up only 1% of all lumbar spine fractures. A burst fracture with neurological compromise, ligamentous injury, severe kyphotic deformity, or loss of anterior column support typically requires surgical stabilization. Treatment options at the L4 and L5 levels are challenging and often require an anterior/posterior approach. Very little has been reported on anterior approaches to the L4 and L5 levels when a corpectomy is required. Hence, we present a patient with a complex burst fracture of L4 and L5. She underwent a corpectomy of L4 and L5 and placement of an expandable cage through a window created between the aorta and the inferior vena cava via an anterior transperitoneal abdominal approach followed by posterior stabilization and fusion from L2 to the pelvis.

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Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra

Likhachev¹,

Zaretskov²,

Арсениевич³

et al. 2021

Sovrem Tehnol Med

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The major management technique for lumbar burst fractures is transpedicular fixation (TPF). However, in relation to fractures of the L 5 vertebra, this tactic often has no advantages over conservative treatment, and, therefore, it is expected to be supplemented with anterior decompression and reconstruction of the anterior column of the L 5 vertebra. The aim of the study was to determine the most optimal treatment tactics for patients with isolated burst fractures of the fifth lumbar vertebra. Materials and Methods We performed a retrospective study of 58 patients treated for isolated burst L 5 fractures. 12 patients refused to undergo surgery and received conservative outpatient treatment. TPF was performed in 27 patients; circular spondylosynthesis (TPF + anterior column support with a Mesh implant) — in 19 patients. The effectiveness of the treatment was assessed by clinical and introscopic research methods. Results The radiological and functional outcomes of surgery with conventional TPF for isolated L 5 burst fractures are generally comparable with the outcomes of conservative treatment. In 26% of the patients, the instability of the metal construction developed within 12 months after surgical intervention. Supplementing the transpedicular system with wedging anterior column support with a Mesh implant ensures preservation in 21%, and improves the parameters of the sagittal profile of the lumbosacral transition in 79% of cases.

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Surgical approaches to L5 corpectomy: a systematic review

Cited by 5 publications

References 7 publications

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

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

Multilevel L4 and L5 Corpectomy for Burst Fracture via an Anterior Transperitoneal Approach Followed by Posterior Stabilization: Technical and Anatomic Considerations

Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra

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