Early experience of endoscopy-assisted anterior spinal surgery.
OBJECTIVE
Endoscopy-assisted anterior spinal surgery is less invasive, resulting in less tissue trauma. It has a shorter recovery period, leads to less morbidity, and is more cost efficient than conventional surgery. We report our early experience of endoscopic anterior spinal surgery in Thailand, which was performed with a basic laparoscopic instrument set and self-developed instruments for spinal surgery.


METHODS
All patients who underwent endoscopic anterior spinal surgery from July 2000 to May 2001 at the Orthopaedic Department, Nakhonpathom Hospital, Nakhonpathom were prospectively documented. The two-portal technique was applied on these patients: the first portal, a 4-cm skin incision, was made as the portal for the surgical instruments; the second portal, a one-cm skin incision, was made as the portal for the endoscope.


RESULTS
Nine patients underwent anterior spinal surgery with the minimally invasive technique. The mean patient age was 51.5 years (range, 17-72 years); 3 patients were females and 6 were males. The procedures included thoracoscopy, retroperitoneoscopy, diaphragmatic crus detachment, discectomy, corpectomy, fusion, and instrumentation. The mean operating time was one hour 58 minutes, and the mean estimated blood loss was 372 ml; there were no serious complications.


CONCLUSIONS
Endoscopy-assisted anterior spinal surgery can be performed without spending a high budget; the procedure is not difficult if the surgeon can develop some instruments and has experiences with arthroscopic surgery and anterior spinal surgery.
Adulkasem
W
W
Orthopaedic Department, Nakhonpathom Hospital, Thesa Road, Muang, Nakhonpathom 73000, Thailand. johnwallop@yahoo.com
Surangsrirat
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D017586:Diskectomy; D019723:Endoscopes; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion; D013906:Thoracoscopy; D016896:Treatment Outcome