title: Minimally invasive surgery for traumatic spinal pathologies: a mini-open, lateral approach in the thoracic and lumbar spine.
abstract: METHODS
  Prospective registry.
  
  
  OBJECTIVE
  The objective of this study was to examine patient outcomes using a mini-open, lateral approach for the treatment of traumatic thoracic and lumbar fractures.
  
  
  BACKGROUND
  The high-quality published studies that examine treatment methods for acute traumatic thoracic and lumbar fractures are few and a few that are present contain insufficient samples to make broad conclusions. Despite this, we know that conventional surgical techniques often include large, morbid exposures. More recent advancements in less invasive surgical techniques have greatly decreased the associated morbidities of conventional approaches, namely, thoracotomy.
  
  
  METHODS
  A total of 52 patients were treated at 1 of 2 institutions for traumatic thoracic or lumbar fractures with a mini-open lateral approach for corpectomy. Patients were prospectively followed for clinical outcomes, with treatment and in-hospital complications collected retrospectively.
  
  
  RESULTS
  The majority of patients (94.2%) presented with traumatic burst fractures with instability and neurologic deficit. Patients were treated with mini-open, lateral corpectomies from T7 to L4, the majority at T12 and L1, and were followed 2 years after surgery. Supplemental internal fixation was used in all patients: 75% anterolateral plating and 46.1% transpedicular fixation (11 [21.2%] patients with combined). Median operative time, estimated blood loss, and hospital stay were 128 minutes, 300 mL, and 4 days, respectively. Complications were observed in 13.5% of patients and no reoperations occurred. Neurologic status, assessed using American Spinal Injury Association categorization, improved significantly postoperatively, with 73% of patients either completely neurologically intact or with only slight residual deficits (American Spinal Injury Association E or D). No patient experienced neurologic deterioration. Expandable wide-footprint titanium cages were used in 34.6% of patients, which resisted radiographic subsidence seen in some patients treated with expandable cylindrical titanium cages.
  
  
  CONCLUSIONS
  The mini-open lateral approach for thoracic and lumbar corpectomy was shown to be safe and effective in this series while avoiding many of the associated morbidities of thoracotomies for anterior column reconstruction and open posterior approaches.
authors.affiliation: Department of Neurosurgery, University Medical Center, Las Vegas, NV, USA. Neurospinedoc@gmail.com
authors.forename: William D
authors.initials: WD
authors.lastname: Smith
authors.forename: Elias
authors.initials: E
authors.lastname: Dakwar
authors.forename: Tien V
authors.initials: TV
authors.lastname: Le
authors.forename: Ginger
authors.initials: G
authors.lastname: Christian
authors.forename: Sherrie
authors.initials: S
authors.lastname: Serrano
authors.forename: Juan S
authors.initials: JS
authors.lastname: Uribe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019637:Orthopedic Procedures / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome