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单一入路经椎间孔胸腰椎椎体切除术联合后路内固定治疗不同临床情况。

Single-Position Transpsoas Corpectomy and Posterior Instrumentation in the Thoracolumbar Spine for Different Clinical Scenarios.

机构信息

Spine Surgery Department, Elite Spine Health and Wellness, Fort Lauderdale, Florida, USA.

Spine Surgery Division, Atlantic Brain and Spine, Wilmington, North Carolina, USA.

出版信息

Oper Neurosurg (Hagerstown). 2023 Mar 1;24(3):310-317. doi: 10.1227/ons.0000000000000523. Epub 2022 Nov 28.

Abstract

BACKGROUND

The concept of single-position spine surgery has been gaining momentum because it has proven to reduce operative time, blood loss, and hospital length of stay with similar or better outcomes than traditional dual-position surgery. The latest development in single-position spine surgery techniques combines either open or posterior pedicle screw fixation with transpsoas corpectomy while in the lateral or prone positioning.

OBJECTIVE

To provide, through a multicenter study, the results of our first patients treated by single-position corpectomy.

METHODS

This is a multicenter retrospective study of patients who underwent corpectomy and instrumentation in the lateral or prone position without repositioning between the anterior and posterior techniques. Data regarding demographics, diagnosis, neurological status, surgical details, complications, and radiographic parameters were collected. The minimum follow-up for inclusion was 6 months.

RESULTS

Thirty-four patients were finally included in our study (24 male patients and 10 female patients), with a mean age of 51.2 (SD ± 17.5) years. Three-quarter of cases (n = 27) presented with thoracolumbar fracture as main diagnosis, followed by spinal metastases and primary spinal infection. Lateral positioning was used in 27 cases, and prone positioning was used in 7 cases. The overall rate of complications was 14.7%.

CONCLUSION

This is the first multicenter series of patients who underwent single-position corpectomy and fusion. This technique has shown to be safe and effective to treat a variety of spinal conditions with a relatively low rate of complications. More series are required to validate this technique as a possible standard approach when thoracolumbar corpectomies are indicated.

摘要

背景

单体位脊柱手术的概念越来越受到关注,因为它已被证明可以缩短手术时间、减少出血量和住院时间,并且与传统的双体位手术相比具有相似或更好的效果。单体位脊柱手术技术的最新进展是将后路或前路椎弓根螺钉固定与经椎间孔椎体切除术相结合,同时采用侧卧位或俯卧位。

目的

通过多中心研究,提供我们首批采用单体位椎体切除术治疗的患者的结果。

方法

这是一项多中心回顾性研究,共纳入 34 例在侧卧位或俯卧位行单纯前路或后路椎体切除和内固定而无需在前后位之间重新定位的患者。收集患者的人口统计学、诊断、神经状态、手术细节、并发症和影像学参数等数据。纳入的最低随访时间为 6 个月。

结果

最终有 34 例患者纳入本研究(男 24 例,女 10 例),平均年龄为 51.2(SD ± 17.5)岁。四分之三的病例(n = 27)以胸腰椎骨折为主要诊断,其次为脊柱转移瘤和原发性脊柱感染。27 例采用侧卧位,7 例采用俯卧位。总的并发症发生率为 14.7%。

结论

这是首例多中心采用单体位椎体切除术和融合术治疗的患者系列研究。该技术已被证明是安全有效的,可用于治疗多种脊柱疾病,并发症发生率相对较低。需要更多的研究来验证该技术作为治疗胸腰椎椎体切除术的一种可能的标准方法。

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