title: Perioperative characteristics, complications, and outcomes of single-level versus multilevel thoracic corpectomies via modified costotransversectomy approach.
abstract: METHODS
  Retrospective case series.
  
  
  OBJECTIVE
  To compare perioperative end points and outcomes of single-level versus multilevel corpectomy performed using a modified costotransversectomy approach.
  
  
  BACKGROUND
  Single-level corpectomy via posterolateral approach has been shown to be an effective alternative to the traditional anterior thoracotomy approach. However, there is a paucity of studies that have examined multilevel thoracic corpectomy via posterolateral approach.
  
  
  METHODS
  Using electronic medical records, we identified a consecutive population of adult patients who underwent modified costotransversectomy corpectomy in the thoracic region between 2006 and 2009. Patients were stratified by number of corpectomies performed into either a single-level or multilevel group. With the use of baseline descriptive statistics and multivariate analysis, perioperative parameters and follow-up outcomes were assessed between the 2 groups.
  
  
  RESULTS
  A total of 40 patients were included in the final analysis, with 25 patients in the single-level group and 15 patients in the multilevel group. Mean follow-up was 16.1 months. Overall complication rate was 37.5%. Between the 2 groups, there were no significant differences in operative time, blood loss, transfusion rate, quantity of blood transfused, length of hospital stay, or complication rates. Also, there were no significant differences in repeat surgery rate, Medical Research Council strength, Nurick score, or pain at most recent follow-up, and all groups gained a comparable magnitude of benefit from surgery.
  
  
  CONCLUSIONS
  Multilevel corpectomy via modified costotransversectomy approach in the thoracic region is a feasible and effective option that does not seem to be associated with significantly increased morbidity. The degree of clinical improvement also seems comparable with single-level corpectomy.
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Darryl
authors.initials: D
authors.lastname: Lau
authors.forename: Yeohan
authors.initials: Y
authors.lastname: Song
authors.forename: Zhe
authors.initials: Z
authors.lastname: Guan
authors.forename: Stephen
authors.initials: S
authors.lastname: Sullivan
authors.forename: Frank
authors.initials: F
authors.lastname: La Marca
authors.forename: Paul
authors.initials: P
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019637:Orthopedic Procedures / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D059035:Perioperative Period / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000601:surgery*; D013997:Time Factors