Konakondla Sanjay, Nakhla Jonathan, Xia Jimmy, Barber Sean M, Fridley Jared S, Oyelese Adetokunbo A, Gokaslan Ziya L, Rainov Nikolai G, Haritonov Dimitar G, Wagner Ralf, Telfeian Albert E
Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI.
MVZ Wirbelsäulenzentrum Taufkirchen b. München, Munich, Germany.
Int J Spine Surg. 2021 Feb;14(s4):S66-S70. doi: 10.14444/7167. Epub 2020 Dec 29.
Conventional approaches to the thoracic spine can require extensive tissue dissection, bony disruption, and instability that may warrant the need for instrumentation and fusion. Furthermore, anterior approaches may require the involvement of various surgeons from multiple disciplines to ensure a successful operation and mitigate complications. Currently, available minimally invasive approaches still require bony removal and usually rely heavily on computed tomography (CT)-guided imaging without direct gross visualization. Endoscopic spinal procedures have provided an ultra-minimally invasive alternative to access many areas in and around the spinal column.
We present a 12-year-old boy with a right-sided 2.0 × 3.2-cm paravertebral lesion at the level of T5. The patient successfully underwent an endoscopic approach to the lesion with minimal tissue and bony disruption for tissue diagnosis and tumor resection.
At initial and 6-month follow-up, the patient remained asymptomatic and without issues.
We demonstrate here the feasibility and suggest the safety of a posterior ultra-minimally invasive endoscopic spinal approach to obtain a tissue biopsy of an incidentally found ventrolateral paraspinal tumor in the thoracic region in a pediatric patient. This minimal approach can prove to achieve similar results as other approaches that may otherwise necessitate more extensive or transthoracic procedures.
传统的胸椎手术方法可能需要广泛的组织解剖、骨质破坏以及导致不稳定,这可能需要进行器械固定和融合。此外,前路手术可能需要多个学科的不同外科医生参与,以确保手术成功并减少并发症。目前,现有的微创方法仍然需要去除骨质,并且通常严重依赖计算机断层扫描(CT)引导成像,而没有直接的肉眼可视化。内镜脊柱手术为进入脊柱及其周围的许多区域提供了一种超微创替代方法。
我们报告一名12岁男孩,在T5水平右侧有一个2.0×3.2厘米的椎旁病变。该患者成功接受了内镜下病变手术,组织和骨质破坏最小,以进行组织诊断和肿瘤切除。
在初次和6个月随访时,患者无症状且无问题。
我们在此证明了后路超微创内镜脊柱手术方法的可行性,并表明其安全性,该方法用于对一名儿科患者胸段偶然发现的腹外侧椎旁肿瘤进行组织活检。这种微创方法可以证明能取得与其他可能需要更广泛或经胸手术的方法相似的结果。