title: Minimally invasive thoracic decompression for multi-level thoracic pathologies.
abstract: We describe our experience using a minimal access approach for multi-level dorsal decompression of the thoracic spine that may limit approach-related soft-tissue injury and spinal destabilization. Additionally, three patients, each with unique compressive thoracic pathology, are discussed. A single minimal access technique, using multi-level hemilaminotomies, was used to address these unique pathologies via a similar approach. The three patients in this study had a mean age of 49.3 years (range: 45-55 years), mean estimated blood loss of 750 cc (range: 350-1000 cc), mean operative time of 3.8 hours (range: 3-5 hours), and a mean post-operative hospital stay of 2.3 days (range: 2-3 days). Complete decompression was achieved with resolution of symptoms in all patients. Long-term follow-up averaged 26.7 months (range: 15-36 months). Radiographic decompression was demonstrated in all patients. Minimal access techniques using muscle-splitting tubular retractor systems can effectively treat multi-level dorsal compression of the thoracic cord, while potentially limiting morbidity and long-term spinal instability.
authors.affiliation: Department of Neurosurgery, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Zachary A
authors.initials: ZA
authors.lastname: Smith
authors.affiliation: Department of Neurosurgery, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Cort D
authors.initials: CD
authors.lastname: Lawton
authors.affiliation: Department of Neurosurgery, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Albert P
authors.initials: AP
authors.lastname: Wong
authors.affiliation: Department of Neurosurgery, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Nader S
authors.initials: NS
authors.lastname: Dahdaleh
authors.affiliation: Department of Neurosurgery, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Nixon
authors.affiliation: Department of Neurosurgery, Northwestern Memorial Hospital, Chicago, IL, USA.
authors.forename: Aruna
authors.initials: A
authors.lastname: Ganju
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, 1725 W. Harrison Street, Suite 855, Chicago, IL 60612, USA. Electronic address: rfessler@rush.edu.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Fessler
mesh_terms: D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013117:Spinal Cord Compression / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome
keywords: Minimally invasive spine; Surgical technique; Thoracic spine