Minimally invasive lateral retropleural thoracolumbar approach

Cadaveric feasibility study and report of 4 clinical cases

Juan S. Uribe, Elias Dakwar, Rafael F. Cardona, Fernando Vale Diaz

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

BACKGROUND: Traditional anterior and posterior approaches to the thoracolumbar spine are associated with significant morbidity. In an effort to eliminate these drawbacks, minimally invasive retropleural approaches have been developed. OBJECTIVE: To demonstrate the feasibility and clinical experience of a minimally invasive lateral retropleural approach to the thoracolumbar spine. METHODS: Seven cadaveric dissections were performed in 7 fresh specimens to determine the feasibility of the technique. In each specimen, the lateral aspect of the vertebral body was accessed retropleurally, and a corpectomy was performed. Intraprocedural fluoroscopy and postoperative computed tomography were used to assess the extent of decompression. As an adjunct, 3 clinical cases of thoracic fractures and 1 neurofibroma were treated with this minimally invasive approach. Operative results, complications, and early outcomes were assessed. RESULTS: In the cadaveric study, adequate exposure was obtained to perform a lateral corpectomy and to allow interbody grafting between the adjacent vertebral bodies. The procedures were successfully performed in the 4 clinical cases without conversion to conventional approaches. A pleural tear was noted in the first clinical case, and a chest tube was placed without any long-term sequelae. CONCLUSION: Our early experience suggests that the minimally invasive lateral retropleural approach allows adequate vertebrectomy and canal decompression without the tissue disruption associated with posterolateral approaches. This approach may improve the complication rates that accompany open or endoscopic approaches for thoracolumbar corpectomies.

Original languageEnglish (US)
JournalNeurosurgery
Volume68
Issue numberSUPPL. 1
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

Fingerprint

Feasibility Studies
Decompression
Spine
Neurofibroma
Chest Tubes
Fluoroscopy
Tears
Dissection
Thorax
Tomography
Morbidity

Keywords

  • Lateral
  • Minimally invasive
  • Retropleural
  • Thoracolumbar

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Minimally invasive lateral retropleural thoracolumbar approach : Cadaveric feasibility study and report of 4 clinical cases. / Uribe, Juan S.; Dakwar, Elias; Cardona, Rafael F.; Vale Diaz, Fernando.

In: Neurosurgery, Vol. 68, No. SUPPL. 1, 01.03.2011.

Research output: Contribution to journalArticle

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