Minimally invasive thoracic decompression for multi-level thoracic pathologies

作者：Smith Zachary A; Lawton Cort D; Wong Albert P; Dandaleh Nader S; Nixon Alexander T; Ganju Aruna; Fessler Richard G^*

来源：Journal of Clinical Neuroscience, 2014, 21(3): 467-472.

DOI：10.1016/j.jocn.2013.07.010

• Minimally invasive spine
• Surgical technique
• Thoracic spine

We describe our experience using a minimal access approach for multi-level dorsal decompression of the thoracic spine that may limit approach-related soft-tissue injury and spinal destabilization. Additionally, three patients, each with unique compressive thoracic pathology, are discussed. A single minimal access technique, using multi-level hemilaminotomies, was used to address these unique pathologies via a similar approach. The three patients in this study had a mean age of 49.3 years (range: 45-55 years), mean estimated blood loss of 750 cc (range: 350-1000 cc), mean operative time of 3.8 hours (range: 3-5 hours), and a mean post-operative hospital stay of 2.3 days (range: 2-3 days). Complete decompression was achieved with resolution of symptoms in all patients. Long-term follow-up averaged 26.7 months (range: 15-36 months). Radiographic decompression was demonstrated in all patients. Minimal access techniques using muscle-splitting tubular retractor systems can effectively treat multi-level dorsal compression of the thoracic cord, while potentially limiting morbidity and long-term spinal instability.

• 出版日期2014-3