Dhall Sanjay S, Wadhwa Rishi, Wang Michael Y, Tien-Smith Alexandra, Mummaneni Praveen V
Department of Neurosurgery, University of California, San Francisco, California; and.
Neurosurg Focus. 2014;37(1):E9. doi: 10.3171/2014.5.FOCUS14108.
Minimally invasive spinal (MIS) surgery techniques have been used sporadically in thoracolumbar junction trauma cases in the past 5 years. A review of the literature on the treatment of thoracolumbar trauma treated with MIS surgery revealed no unifying algorithm to assist with treatment planning. Therefore, the authors formulated a treatment algorithm.
The authors reviewed the current literature on MIS treatment of thoracolumbar trauma. Based on the literature review, they then created an algorithm for the treatment of thoracolumbar trauma utilizing MIS techniques. This MIS trauma treatment algorithm incorporates concepts form the Thoracolumbar Injury Classification System (TLICS).
The authors provide representative cases of patients with thoracolumbar trauma who underwent MIS surgery utilizing the MIS trauma treatment algorithm. The cases involve the use of mini-open lateral approaches and/or minimally invasive posterior decompression with or without fusion.
Cases involving thoracolumbar trauma can safely be treated with MIS surgery in select cases of burst fractures. The role of percutaneous nonfusion techniques remains very limited (primarily to treat thoracolumbar trauma in patients with a propensity for autofusion [for example, those with ankylosing spondylitis]).
在过去5年中，微创脊柱（MIS）手术技术已偶尔用于胸腰段交界处创伤病例。对有关MIS手术治疗胸腰段创伤的文献综述显示，尚无统一的算法来辅助治疗规划。因此，作者制定了一种治疗算法。
作者回顾了目前有关MIS治疗胸腰段创伤的文献。基于文献综述，他们随后创建了一种利用MIS技术治疗胸腰段创伤的算法。这种MIS创伤治疗算法纳入了胸腰段损伤分类系统（TLICS）的概念。
作者提供了采用MIS创伤治疗算法接受MIS手术的胸腰段创伤患者的代表性病例。这些病例包括使用迷你开放外侧入路和/或微创后路减压，伴或不伴融合。
在爆裂骨折的特定病例中，涉及胸腰段创伤的病例可以通过MIS手术安全治疗。经皮非融合技术的作用仍然非常有限（主要用于治疗有自发融合倾向的患者的胸腰段创伤[例如，强直性脊柱炎患者]）。
