Minimally Invasive Thoracolumbar Corpectomy and Stabilization for Unstable Burst Fractures Using Intraoperative Computed Tomography and Computer-Assisted Spinal Navigation.
World Neurosurg
; 122: e1266-e1274, 2019 Feb.
Article
en En
| MEDLINE
| ID: mdl-30447453
ABSTRACT
BACKGROUND:
Minimally invasive surgery using a mini-open lateral retropleural or retroperitoneal approach for corpectomy is a well-described procedure for treating unstable thoracolumbar burst fractures. Most surgeons have incorporated fluoroscopy for localization and determination of hardware placement accuracy; however, the utility of computer-assisted image-guided spinal navigation has not been well described. We report a series of mini-open lateral approach thoracolumbar corpectomy cases using either fluoroscopy or intraoperative computed tomography (iCT) with computer-assisted navigation and discuss the technical nuances and advantages of using iCT with navigation versus fluoroscopy.METHODS:
A retrospective review and analysis was performed of the cases of 20 patients with thoracolumbar burst fractures surgically managed via mini-open lateral corpectomy with fluoroscopy (2013-2015) or iCT navigation (2015-2017). The surgical outcomes were evaluated by the estimated blood loss, operative time, hospital stay, and need for revision. The clinical outcomes were evaluated using the numerical rating scale pain score. Radiographic outcomes were assessed with follow-up CT scans. The results were statistically analyzed using the Wilcoxon-Mann-Whitney test.RESULTS:
The mean follow-up period was 13.4 months for the fluoroscopy group and 14.7 months for the iCT group. No surgical complications developed and no revisions were required. No statistically significant differences were found between the groups in surgical or clinical outcomes. However, the radiation exposure to the surgeons was significantly less with the iCT group (P < 0.003).CONCLUSIONS:
The use of iCT with spinal navigation for mini-open lateral corpectomy for thoracolumbar burst fractures yields perioperative and clinical outcomes comparable to those using traditional fluoroscopy, with decreased radiation exposure to surgeons.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Vértebras Torácicas
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Tomografía Computarizada por Rayos X
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Procedimientos Quirúrgicos Mínimamente Invasivos
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Neuronavegación
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Vértebras Lumbares
Límite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
World Neurosurg
Asunto de la revista:
NEUROCIRURGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos