title: [Minimally invasive extrapleural retroperitoneal approach for thoracolumbar junction. Prospective study of 40cases].
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  The anterior spinal cord decompression and spinal interbody fusion is considered an effective therapeutic procedure for thoracolumbar spine junction (TLSJ) (T11 to L2) fractures and tumors. However, it is also known to be associated with considerable surgery-related trauma. The purpose of this study was to show that neural elements decompression and anterior reconstruction at the TLSJ can be performed via a minimally invasive extrapleural retroperitonal approach (MIERA).
  
  
  METHODS
  The authors studied prospectively the hospital records and radiological data obtained in 40 patients (mean age: 43.6 years, range: 16-74 years) who all underwent first a posterior fixation followed by a thoracic (T11 or T12) or lumbar (L1 or L2) corpectomy and spinal fusion via a MIERA.
  
  
  RESULTS
  The MIERA provided excellent exposure to facilitate complete decompression and anterior reconstruction in all patients, as verified on follow-up radiographic studies. More than 2years follow-up record is available for 24 patients, a one year follow-up record for 14 others, and six months follow-up for the last two ones. Radiography demonstrated anatomically correct reconstruction in all patients, as well as a solid fusion or a stable compound union in the 24patients for whom a minimum of 2years follow-up records was available.
  
  
  CONCLUSIONS
  The MIERA allows the surgeon to perform anterior thoracolumbar spine surgery via a less invasive approach. The authors demonstrate the efficacy and safety of this technique and its potential to reduce perioperative morbidity compared with conventional retroperitoneal lumbar spine surgery or thoracophrenolombotomy.
authors: Service de neurochirurgie, CHU de La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors: C F
authors: CF
authors: Litré
authors: Y
authors: Y
authors: Benhima
authors: G
authors: G
authors: Pech-Gourg
authors: S
authors: S
authors: Malikov
authors: B
authors: B
authors: Blondel
authors: P
authors: P
authors: Métellus
authors: S
authors: S
authors: Fuentes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D012187:Retroperitoneal Space; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult