Gandhoke Gurpreet S, Tempel Zachary J, Bonfield Christopher M, Madhok Ricky, Okonkwo David O, Kanter Adam S
Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Suite B-400, Pittsburgh, PA, 15213, USA.
Eur Spine J. 2015 Apr;24 Suppl 3:353-60. doi: 10.1007/s00586-015-3880-7. Epub 2015 Mar 24.
Contemporary minimally invasive techniques have evolved to enable direct access to the anterior spinal column via the extreme lateral approach. We have employed this access approach to treat selected burst fractures. We report our technique. Thoracolumbar burst fractures that require surgical intervention have traditionally been managed with anterior, posterior, or combined approaches.
We have applied the minimally invasive extreme lateral approach to perform vertebral corpectomy, cage placement, and lateral instrumentation to treat burst fractures. Indications for surgery were incomplete spinal cord injury with persistent neural element compression due to ventral fracture fragments in the canal. We present the technical nuances of this surgical approach for the treatment of thoracolumbar burst fractures with two case illustrations.
There were no peri- or intra-operative complications. Both patients in our series remained neurologically intact at their last follow-up (11 and 29 months, respectively), and maintained their correction of kyphosis.
The minimally invasive extreme lateral approach is an effective treatment option for the management of thoracolumbar burst fractures.
当代微创技术不断发展，已能够通过极外侧入路直接进入脊柱前路。我们采用这种入路方法治疗特定的爆裂骨折。我们报告我们的技术。传统上，需要手术干预的胸腰椎爆裂骨折采用前路、后路或联合入路进行治疗。
我们应用微创极外侧入路进行椎体次全切除、椎间融合器置入和侧方内固定，以治疗爆裂骨折。手术指征为因椎管内腹侧骨折块导致脊髓损伤不完全且存在持续神经结构受压。我们通过两个病例说明展示这种手术方法治疗胸腰椎爆裂骨折的技术细节。
无围手术期或术中并发症。我们系列中的两名患者在最后一次随访时（分别为11个月和29个月）神经功能均保持完整，并维持了后凸畸形的矫正。
微创极外侧入路是治疗胸腰椎爆裂骨折的一种有效治疗选择。
