Abordajes anteriores mini-open en el raquis toracolumbar / Mini-open approaches in anterior lumbar spine surgery

Introducción El abordaje anterior vertebral conocido como mini-open fue introducido hace unos años para el tratamiento quirúrgico de la patología del raquis. Dicho abordaje permite la exposición directa de las estructuras anteriores, cuerpo y disco intervertebral, la descompresión anterior del saco dural y la reconstrucción y/o estabilización de los niveles de interés con un sistema adecuado. En el presente trabajo presentamos nuestra experiencia en mini-open anterior spine surgery (MOASS) en el abordaje anterior del raquis para tratamiento de patología del raquis toracolumbar. Material y métodos En el periodo entre enero de 2004 y julio de 2011 hemos realizado 74 abordajes anteriores de columna mediante cirugía abierta. En 38 casos utilizamos la técnica MOASS a distintos niveles: torácico, lumbar e infraumbilical extraperitoneal. Resultados No tuvimos mortalidad quirúrgica ni postoperatoria, ni déficits neurológicos añadidos derivados del acto quirúrgico, en ninguna de las técnicas (clásica versus MOASS). Las complicaciones fueron escasas y corregidas con el adecuado tratamiento. Conclusiones Mediante la técnica MOASS hemos realizado la corrección quirúrgica de lesiones vertebrales que pueden afectar al raquis toracolumbar, con resultados similares a los obtenidos mediante el abordaje clásico y ventajas reseñables (AU)

Introduction The anterior spine approach known as «mini-open» was introduced a few years ago for the surgical treatment of spine diseases. This approach allows the anterior, body and intervertebral disc structures to be exposed, as well as the anterior compression of the dural sac and the reconstruction and/or stabilisation of the levels of interest with an appropriate system. In the present article we present our experience in mini-open anterior spine surgery (MOASS) approach in the treatment of lumbar spine diseases. Material and methods We performed 74 anterior spine approaches using open surgery between the period January 2004 and July 2011. In 38 cases we used the MOASS technique at different levels: thoracic, lumbar, and infraumbilical extraperitoneal. Results There were no surgical or post-operative deaths, or further neurological deficits arising from the surgical procedure in any of the techniques (classic versus MOASS). The few complications were corrected with the appropriate treatment. Conclusions Using the MOASS technique we have performed corrective surgery on spine injuries that could affect the thoracic spinal column, with similar results to those obtained using the classic approach and with obvious advantages (AU)

[Mini-open approaches in anterior lumbar spine surgery]. / Abordajes anteriores mini-open en el raquis toracolumbar.

INTRODUCTION: The anterior spine approach known as «mini-open¼ was introduced a few years ago for the surgical treatment of spine diseases. This approach allows the anterior, body and intervertebral disc structures to be exposed, as well as the anterior compression of the dural sac and the reconstruction and/or stabilisation of the levels of interest with an appropriate system. In the present article we present our experience in mini-open anterior spine surgery (MOASS) approach in the treatment of lumbar spine diseases. MATERIAL AND METHODS: We performed 74 anterior spine approaches using open surgery between the period January 2004 and July 2011. In 38 cases we used the MOASS technique at different levels: thoracic, lumbar, and infraumbilical extraperitoneal. RESULTS: There were no surgical or post-operative deaths, or further neurological deficits arising from the surgical procedure in any of the techniques (classic versus MOASS). The few complications were corrected with the appropriate treatment. CONCLUSIONS: Using the MOASS technique we have performed corrective surgery on spine injuries that could affect the thoracic spinal column, with similar results to those obtained using the classic approach and with obvious advantages.

Clinical-therapeutic management of thoracoscopy in pleural effusion: a groundbreaking technique in the twenty-first century.

INTRODUCTION: The aim of this study was to investigate the effectiveness of thoracoscopy in the diagnosis of non-affiliated pleural effusions (PE). MATERIAL AND METHODS: A five-year prospective study including data from 110 patients that were clinically diagnosed as benign (14.5%), malign (34.5%) and non-affiliated (50.9%). PE in patents without oncology disease and negative biopsy or cytology were considered as benign. Malignant diagnosis was established according to a pleural biopsy, compatible cytology and/or clinical features. Remaining cases were considered as non-affiliated. Thoracoscopy was done under local anaesthesia and sedation. RESULTS: Thoracoscopy confirmed previous clinical diagnosis of benignity and malignity. Regarding non-affiliated patients, 30.35% were diagnosed after thoracoscopy as unspecific pleuritis, 17.86% mesothelioma and 1.79% pleural tuberculosis (TBC). The other 48.21% of patients reported as non-affiliated were diagnosed with pleural carcinoma. Statistical analysis did not reveal differences between frequencies analysed. CONCLUSIONS: Our results indicate that thoracoscopy is a cost-effective and reliable technique for obtaining histological diagnosis in PE and also allows a directed pleurodesis if indicated.