Minimally invasive posterior osteotomies.
OBJECTIVE
Surgery for thoracolumbar deformity can lead to significant muscle injury, excessive blood loss, and severe postoperative pain. The aim of the following studies was to determine the feasibility of minimally invasive posterior thoracic corpectomy and thoracolumbar osteotomy techniques for deformity in human cadavers and select clinical cases.


METHODS
Human cadaveric specimens were procured for thoracic corpectomy and Smith-Petersen and pedicle subtraction osteotomy using a minimally invasive approach. Post-procedural computed tomography was used to assess the degree of decompression following corpectomy and the extent of bone resection after osteotomy. Pre and post-osteotomy closure Cobb angles were measured to evaluate the degree of correction achieved.


RESULTS
The minimally invasive lateral extracavitary approach for thoracic corpectomy provided adequate exposure and allowed excellent spinal canal decompression while minimizing tissue disruption. Nearly complete osteotomies of both types could be achieved through a tubular retractor with a modest change in Cobb angle.


CONCLUSIONS
These techniques may play a role in deformity surgery for select cases with further technological advancements.
Voyadzis
Jean-Marc
JM
Department of Neurosurgery, Georgetown University Hospital, Washington, DC, USA. jmvoyadzis@hotmail.com
Gala
Vishal C
VC
O'Toole
John E
JE
Eichholz
Kurt M
KM
Fessler
Richard G
RG
D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D013122:Spinal Diseases / Q000473:pathology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery