PURPOSE: Patients requiring anterior-posterior thoracic spine stabilization and suffering from concomitant cardiopulmonary disease are at increased risk to develop procedure-related complications. In order to reduce cardiopulmonary complications, the efficacy of a posterolateral transpedicular approach for 360-degree fusion was investigated. METHODS: Fourteen consecutive patients presenting with spinal cord compression from osteoporotic, metastatic and tuberculotic fractures were treated. Spinal cord decompression was achieved by laminectomy, facetectomy and corpectomy with subsequent posterior instrumented fusion using a screw-rod system. RESULTS: The procedure was successfully performed in 14 high-risk patients. Preoperatively, all patients presented with thoracic and lower back pain and nine patients with a paraparesis (Frankel grade C). The implants were introduced monoportally or biportally. In all cases, neurological symptoms moderately improved. CONCLUSION: The posterolateral transpedicular approach might be a safe, less-invasive and efficient alternative to anterior-posterior fusion. However, biomechanic efficacy and long-term outcome as compared to the transthoracic technique remains to be studied in a larger patient cohort.
PURPOSE:Patients requiring anterior-posterior thoracic spine stabilization and suffering from concomitant cardiopulmonary disease are at increased risk to develop procedure-related complications. In order to reduce cardiopulmonary complications, the efficacy of a posterolateral transpedicular approach for 360-degree fusion was investigated. METHODS: Fourteen consecutive patients presenting with spinal cord compression from osteoporotic, metastatic and tuberculotic fractures were treated. Spinal cord decompression was achieved by laminectomy, facetectomy and corpectomy with subsequent posterior instrumented fusion using a screw-rod system. RESULTS: The procedure was successfully performed in 14 high-risk patients. Preoperatively, all patients presented with thoracic and lower back pain and nine patients with a paraparesis (Frankel grade C). The implants were introduced monoportally or biportally. In all cases, neurological symptoms moderately improved. CONCLUSION: The posterolateral transpedicular approach might be a safe, less-invasive and efficient alternative to anterior-posterior fusion. However, biomechanic efficacy and long-term outcome as compared to the transthoracic technique remains to be studied in a larger patient cohort.
Authors: Claudia Druschel; A C Disch; I Melcher; T Engelhardt; A Luzzati; N P Haas; K D Schaser Journal: Eur Spine J Date: 2011-08-05 Impact factor: 3.134
Authors: Jeremy C Wang; Patrick Boland; Nandita Mitra; Yoshiya Yamada; Eric Lis; Michael Stubblefield; Mark H Bilsky Journal: J Neurosurg Spine Date: 2004-10
Authors: Marc Dreimann; Michael Hoffmann; Lennart Viezens; Lukas Weiser; Patrick Czorlich; Sven Oliver Eicker Journal: Eur Spine J Date: 2016-10-11 Impact factor: 3.134
Authors: Marc Dreimann; Axel Hempfing; Martin Stangenberg; Lennart Viezens; Lukas Weiser; Patrick Czorlich; Sven Oliver Eicker Journal: Neurosurg Rev Date: 2017-03-09 Impact factor: 3.042