title: Mini-Open Thoracolumbar Corpectomy: Perioperative Outcomes and Hospital Cost Analysis Compared with Open Corpectomy.
abstract: BACKGROUND
  Standard open surgical management of thoracolumbar infection, trauma, and tumor is associated with significant morbidity. We compared perioperative and immediate postoperative morbidity of open and mini-open thoracolumbar corpectomy techniques including direct hospital costs.
  
  
  METHODS
  We retrospectively reviewed medical records of all patients who underwent open or mini-open corpectomy. Demographics (age, sex, body mass index, primary diagnosis), operative data (length of surgery, estimated blood loss, blood transfusion), surgical level, preoperative and postoperative neurologic status (using American Spinal Injury Association Impairment Scale), immediate perioperative complications (within 30 days postoperatively), overall length of stay from admission, length of stay from surgery, and total direct hospital costs were tabulated and analyzed.
  
  
  RESULTS
  The study included 43 patients, 20 (46.51%) undergoing open corpectomy and 23 (53.48%) undergoing mini-open corpectomy. Clinical and statistically significant findings in favor of mini-open corpectomy included lower estimated blood loss (1305 mL vs. 560 mL, P = 0.0072), less blood transfusion (241 mL vs. 667 mL, P = 0.029), shorter overall length of stay (7.2 days vs. 12.2 days, P = 0.047), and shorter surgery time (376 minutes vs. 295 minutes, P = 0.035) as well as lower total direct hospital cost ($34,373 vs. $45,376, P = 0.044). There was no statistically significant difference in postoperative complications between the 2 groups (medical complications 5% vs. 4.3%, P = 0.891; surgical complications 5% vs. 8.69%, P = 0.534).
  
  
  CONCLUSIONS
  Mini-open TL corpectomy is a safe, cost-effective, clinically effective, and less morbid alternative to standard open thoracotomy surgical techniques.
authors.affiliation: Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA.
authors.forename: Olawale A R
authors.initials: OAR
authors.lastname: Sulaiman
authors.affiliation: Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA. Electronic address: jgarcesmd@gmail.com.
authors.forename: Juanita
authors.initials: J
authors.lastname: Garces
authors.affiliation: Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Division of Neurosurgery, Department of Surgery, Jazan University, Jazan, USA.
authors.forename: Mansour
authors.initials: M
authors.lastname: Mathkour
authors.affiliation: Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Scullen
authors.affiliation: Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Jones
authors.affiliation: Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Arrington
authors.affiliation: Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
authors.forename: Cuong J
authors.initials: CJ
authors.lastname: Bui
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000191:economics / Q000379:methods*; D061646:Operative Time; D010019:Osteomyelitis / Q000601:surgery*; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology*; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000556:secondary / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome
keywords: Cost-effectiveness; Mini-open corpectomy; Open corpectomy; Perioperative outcome; Spine infection; Spine trauma; Spine tumor