Video-assisted thoracoscopic treatment of spinal lesions in the thoracolumbar junction

Huang, Tsung-Jen; Hsu, Robert Wen Wei; Liu, H. P.; Hsu, Kuo-Yao; Liao, Yi; Shih, Hong-Mo; Chen, Y. J.

doi:10.1007/s004649900566

Cited by 44 publications

(25 citation statements)

References 10 publications

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“…A proper comparative evaluation will require more extended studies. However, our results of this preliminary study are comparable in these points with other studies on minimally invasive techniques [1,3,4,6,8,9,12,16,19,21,22].…”

Section: Discussionsupporting

confidence: 89%

“…Improvements in technology have allowed the surgeon to enter body cavities and create potential spaces such as the retroperitoneum by diaphragm splitting. Improved fiber optics, light sources, and use of 30°angled optic cameras have resulted in improved visualization of the structures surrounding the spine [1,3,4,5,6,7,8,9,10,11,13,15,16,17,18,20,21,22,23]. Indications for endoscopic spinal surgery are degenerative diseases, infection, tumor, fracture, and ventral release for scoliosis and kyphosis.…”

mentioning

confidence: 99%

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Minimally invasive ventral spondylodesis for thoracolumbar fracture treatment: surgical technique and first clinical outcome

Schultheiß

Kinzl

Wilke

et al. 2003

European Spine Journal

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IntroductionMinimally invasive techniques are becoming more widespread in the surgical subspecialties. Standard open surgical procedures are being modified to become less invasive, with the intention of reducing recovery time, morbidity, and ultimately expenditure. Improvements in technology have allowed the surgeon to enter body cavities and create potential spaces such as the retroperitoneum by diaphragm splitting. Improved fiber optics, light sources, and use of 30°angled optic cameras have resulted in improved visualization of the structures surrounding the spine [1,3,4,5,6,7,8,9,10,11,13,15,16,17,18,20,21,22,23]. Indications for endoscopic spinal surgery are degenerative diseases, infection, tumor, fracture, and ventral release for scoliosis and kyphosis. This minimally incisional technique provides a feasible alternative to thoracotomy or posterolateral approaches for decompression and vertebral body reconstruction. Long distance overbridging by strut graft and stabilization plays an important role, especially in cases of fracture treatment with the need for spinal decompression, sometimes of several segments. However, there is a lack of adequate instrumentation systems. In the early days of endoscopic thoracolumbar fracture treatment, the established standard intervention was performed after dorsal intervention and reduction and secondary mono-or bisegmental ventral strut grafting with overbridging by four-point stabilization with the Z-plate. However, the Z-plate normally is intended for an open implantation technique. Only time-consuming improvisation, such as screw fixation with strings to prevent loosening, make it applicable in these cases [1,4,19]. McAfee, Regan and Bühren concluded that the limiting factor in the wide application of the endoscopic technique is the absence of a commercially available internal fixation system for this endoscopic approach [4,17,21].The purpose of this study was to prospectively evaluate the feasibility, safety and efficacy of a newly developed anterior stabilization system that allows a complete Abstract A new instrumentation system for ventral stabilization of the spine that can be used for an endoscopic and minimally invasive approach was developed. We describe the implantation technique and report on the first clinical results. This prospective study covers the first 45 patients to undergo this new technique since it was introduced in 1999. In all patients the operation was successfully performed in a completely minimally invasive procedure. Mono-and bisegmental stabilization was performed mainly at the thoracolumbar junction after initial posterior instrumentation in most cases. Lesions varied from fresh/old fractures to metastases (T5-L3). Preand postoperative follow-up included clinical examination and radiological visualization via X-ray and computed tomographic scan. Our experience with this minimally invasive procedure demonstrated the feasibility of the method.

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Minimally invasive ventral spondylodesis for thoracolumbar fracture treatment: surgical technique and first clinical outcome

Schultheiß

Kinzl

Wilke

et al. 2003

European Spine Journal

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“…Indications for thoracoscopic spine release in scoliotic deformities Seven years after its introduction, thoracoscopic spine release is not yet widely practised compared with the large number cases of isolated posterior spinal fusion and/or isolated anterior spine instrumentation; we found only 151 cases of such releases reported in the literature [5,6,8,12,14,[16][17][18][19][20]. This is not surprising as an excellent result can be achieved in most scoliotic deformities with straightforward posterior or anterior instrumentation.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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

Arlet

2000

European Spine Journal

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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.

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“…Minimally invasive techniques are becoming more widespread, especially in anterior spinal surgery, due to improved technologies [3,4,5,14,16,22,24,25,29]. Stabilization plays an important role in spinal fracture treatment.…”

Section: Introductionmentioning

confidence: 99%

Solvent-preserved, bovine cancellous bone blocks used for reconstruction of thoracolumbar fractures in minimally invasive spinal surgery?first clinical results

et al. 2004

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Video-assisted thoracoscopic treatment of spinal lesions in the thoracolumbar junction

Cited by 44 publications

References 10 publications

Minimally invasive ventral spondylodesis for thoracolumbar fracture treatment: surgical technique and first clinical outcome

Minimally invasive ventral spondylodesis for thoracolumbar fracture treatment: surgical technique and first clinical outcome

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

Solvent-preserved, bovine cancellous bone blocks used for reconstruction of thoracolumbar fractures in minimally invasive spinal surgery?first clinical results

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