Minimally Invasive Corpectomy in Metastatic Thoracolumbar Spine Disease:The Posterolateral Transpedicular Approach

Eleftherios Archavlis, Nikos Papadopoulos, Peter Ulrich


Study design: Retrospective review of prospectively collected data.
Background: There is no consensus regarding the ideal approach for corpectomy in destructive metastatic thoracolumbar spine disease. Many surgical techniques have been described but none has proved its definite superiority. The main drawback of these procedures is directly related to the morbidity of the approach. As one-stage minimally invasive pedicle screw fixation combined with mini-open posterolateral transpedicular corpectomy for treatment of thoracolumbar metastatic lesions is gaining popularity, its efficacy has yet to be established.
Purpose: The purpose of this study is to report operative data, clinical and radiological outcomes of patients undergoing minimally invasive stabilization, decompression, transpedicular corpectomy and anterior column reconstruction of thoracolumbar metastatic disease at our institutions.
Methods: Forty patients underwent minimally invasive pedicle screws stabilization, mini open decompression and transpedicular corpectomy for treatment of single-level metastatic destruction of the thoracic or lumbar spine. All patients were neurologically intact. There were 19 males and 21 females with an average age of 58 years.
Results: The mean follow-up was 17 months (7—2 1 months). The mean operative time was 256 min (230-390 min) and the mean blood loss was 1350 mL. VAS was significantly improved from 6.7 to 0.7 at last follow-up. Vertebral kyphosis decreased by 16◦ to 7.8◦ postoperatively (P < 0.001). Local kyphosis and percentage of collapse were also significantly improved from 8◦ to 5.6◦ and from 35% to 16% at last follow-up. No patient worsened his or her neurological condition postoperatively.
Conclusion: Minimally invasive transpedicular corpectomy seems to be a safe and effective technique to manage thoracolumbar fractures without neurological impairment.

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