title: Minimally Invasive 2D Navigation-Assisted Treatment of Thoracolumbar Spinal Fractures in East Africa: A Case Report.
abstract: Spinal surgery under Eastern-African circumstances is technically demanding and associated with significant complications, such as blood loss, infection, and wound breakdown. We report a spinal trauma case that was performed using minimally invasive surgery (MIS) and navigation, and hypothesize that these newer techniques may enable surgeons to perform effective spinal surgery with minimal complications and good outcomes.  During the 2014 First Hands-on Neurotrauma Course held in Dar es Salaam, Tanzania, we successfully performed three minimally invasive and two-dimensional (2D) navigated spinal surgeries to decompress and stabilize patients with complete and incomplete spinal injuries. In this report, we present a case of a paraplegic patient with a T12 burst fracture who tolerated MIS surgery with no intraoperative complications, and is doing well with no postoperative complications one year after surgery. Minimally invasive spinal surgery and 2D navigation may offer advantages in resource-poor countries. As part of the Weill Cornell Tanzania Neurosurgery project and in conjunction with the Foundation for International Education in Neurological Surgery (as well as other organizations), further experiences with 2D navigation and MIS surgery will be recorded in 2015. A neurotrauma registry has already been implemented to better understand the current management of neurotrauma in Eastern Africa.
authors.affiliation: Department of Neurosurgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York.
authors.forename: Innocent
authors.initials: I
authors.lastname: Njoku
authors.affiliation: Department of Orthopedics, Muhimbili Orthopedic Institute (MOI), Dar es Salaam, Tanzania ; Department of Neurosurgery, Muhimbili Orthopedic Institute (MOI), Dar es Salaam, Tanzania.
authors.forename: Othman
authors.initials: O
authors.lastname: Wanin
authors.affiliation: Department of Orthopedics, Muhimbili Orthopedic Institute (MOI), Dar es Salaam, Tanzania.
authors.forename: Anthony
authors.initials: A
authors.lastname: Assey
authors.affiliation: Department of Neurosurgery, Muhimbili Orthopedic Institute (MOI), Dar es Salaam, Tanzania.
authors.forename: Hamisi
authors.initials: H
authors.lastname: Shabani
authors.affiliation: Department of Orthopedics, Muhimbili Orthopedic Institute (MOI), Dar es Salaam, Tanzania.
authors.forename: Japhet G
authors.initials: JG
authors.lastname: Ngerageza
authors.affiliation: Department of Neurosurgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York.
authors.forename: Connor D
authors.initials: CD
authors.lastname: Berlin
authors.affiliation: Department of Neurosurgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York.
authors.forename: Roger
authors.initials: R
authors.lastname: Härtl
keywords: global health; minimally invasive spine surgery (miss); neuronavigation; neurosurgery; neurotrauma; spinal trauma; surgery as a global health issue