Le Hai, Barber Joshua, Phan Eileen, Hurley Richard K, Javidan Yashar
University of California, Davis, Sacramento, CA, USA.
Brooke Army Medical Center, Fort Sam Houston, TX, USA.
Global Spine J. 2022 Jan;12(1):29-36. doi: 10.1177/2192568220945291. Epub 2020 Aug 5.
Retrospective case series.
To report our experience with corpectomy of the thoracolumbar (TL) spine through a minimally invasive lateral retropleural or retroperitoneal approach.
This is a retrospective case series of 20 consecutive patients who underwent minimally invasive TL corpectomy and spinal reconstruction. Electronic medical records were reviewed for demographic, operative, and clinical outcome data.
Between 2015 and 2019, 20 consecutive cases of minimally invasive TL corpectomy were performed, comprising 12 men (60%) and 8 women (40%) with a mean age of 54.3 years. Indications for surgery were infection (n = 6, 30%), metastatic disease (n = 2, 10%), fracture (n = 6, 30%), and calcified disc herniation (n = 6, 30%). Partial and complete corpectomy was performed in 5 patients (25%) and 15 patients (75%), respectively. Mean operative time and estimated blood loss was 276.2 minutes and 558.4 mL, respectively. Mean length of stay from admission and surgery were 14.6 and 11.4 days, respectively. Mean length of stay from surgery for elective cases was 4.2 days. Mean follow-up time was 330.4 days. Visual analogue scale score improved from 7.7 to 4.5 ( < .01). There were a total of 3 postoperative complications in 2 patients, including 1 mortality for urosepsis. One patient had revision spinal surgery for adjacent segment disease.
Corpectomy and reconstruction of the TL spine is feasible and safe using a minimally invasive lateral retropleural or retroperitoneal approach. Since this is a relatively new technique, more studies are needed to compare the short- and long-term radiographic and clinical outcomes between minimally invasive versus open corpectomy of the TL spine.
回顾性病例系列研究。
报告我们通过微创侧方胸膜后或腹膜后入路行胸腰椎（TL）椎体次全切除术的经验。
这是一项对20例连续接受微创TL椎体次全切除术及脊柱重建术患者的回顾性病例系列研究。查阅电子病历以获取人口统计学、手术及临床结局数据。
2015年至2019年，连续进行了20例微创TL椎体次全切除术，其中男性12例（60%），女性8例（40%），平均年龄54.3岁。手术指征包括感染（n = 6，30%）、转移性疾病（n = 2，10%）、骨折（n = 6，30%）和钙化椎间盘突出（n = 6，30%）。分别有5例（25%）患者行部分椎体次全切除术，15例（75%）患者行完全椎体次全切除术。平均手术时间和估计失血量分别为276.2分钟和558.4毫升。从入院到手术的平均住院时间和从手术到出院的平均住院时间分别为14.6天和11.4天。择期手术患者术后平均住院时间为4.2天。平均随访时间为330.4天。视觉模拟评分从7.7分改善至4.5分（P <.01）。共有2例患者出现3例术后并发症，包括1例因尿脓毒症死亡。1例患者因相邻节段疾病接受了翻修脊柱手术。
采用微创侧方胸膜后或腹膜后入路行TL椎体次全切除术及重建术是可行且安全的。由于这是一项相对较新的技术，需要更多研究来比较微创与开放TL椎体次全切除术的短期和长期影像学及临床结局。
