J Burgos1, J M Rapariz, P Gonzalez-Herranz. 1. Department of Infant Orthopedics, Hospital Ramon y Cajal, University Alcala de Henares, Madrid, Spain.
Abstract
STUDY DESIGN: A technique for anterior endoscopic exposure of the thoracolumbar spine is described. OBJECTIVE: To develop an endoscopic approach to the thoracolumbar spine with fewer complications than are encountered in the conventional approach. SUMMARY OF BACKGROUND DATA: The efficacy of the anterior endoscopic approach to the thoracic spine has been shown. The thoracolumbar hinge is usually approached by open surgery. METHODS: The study was performed in three stages. The first phase was carried out on experimental animals (pigs). Once the bases were established, the approach was studied in fresh cadavers. Finally, it was performed on three patients with thoracolumbar scoliosis who required discectomy and anterior release. RESULTS: After a series of attempts on the animals, it was found that the most effective method for exposure of the thoracolumbar spine was the initial thoracoscopic approach followed by the retroperitoneal endoscopic approach. This was confirmed in cadavers. When applied to the clinical situation, there were no significant complications in any of the patients treated with this method, and postoperative pain and discomfort were minimal. CONCLUSIONS: The anterior endoscopic approach to the lumbar spine involves minor trauma, results in rapid recovery and less pain, and produces good results aesthetically.
STUDY DESIGN: A technique for anterior endoscopic exposure of the thoracolumbar spine is described. OBJECTIVE: To develop an endoscopic approach to the thoracolumbar spine with fewer complications than are encountered in the conventional approach. SUMMARY OF BACKGROUND DATA: The efficacy of the anterior endoscopic approach to the thoracic spine has been shown. The thoracolumbar hinge is usually approached by open surgery. METHODS: The study was performed in three stages. The first phase was carried out on experimental animals (pigs). Once the bases were established, the approach was studied in fresh cadavers. Finally, it was performed on three patients with thoracolumbar scoliosis who required discectomy and anterior release. RESULTS: After a series of attempts on the animals, it was found that the most effective method for exposure of the thoracolumbar spine was the initial thoracoscopic approach followed by the retroperitoneal endoscopic approach. This was confirmed in cadavers. When applied to the clinical situation, there were no significant complications in any of the patients treated with this method, and postoperative pain and discomfort were minimal. CONCLUSIONS: The anterior endoscopic approach to the lumbar spine involves minor trauma, results in rapid recovery and less pain, and produces good results aesthetically.
Authors: H Bozkus; N R Crawford; R H Chamberlain; T D Valenzuela; A Espinoza; Z Yüksel; C A Dickman Journal: Surg Endosc Date: 2005-10-05 Impact factor: 4.584