Mini-Open Lateral Approach for Corpectomy in the Thoracolumbar Spine

Overview

Journal Int J Spine Surg

Date 2022 Apr 7

PMID 35387886

Authors

Joelle N Hartke

Dimitri Benner

S Harrison Farber

Jay D Turner

Juan S Uribe

Affiliations

Soon will be listed here.

Abstract

The thoracolumbar spine poses unique challenges when considering surgical treatment options. In the era of modern medicine, nonoperative treatments have become more available for pathology of the thoracolumbar spine, including infectious, oncologic, traumatic, and degenerative etiologies. However, surgery is often warranted in the presence of deformity or with spinal cord compression resulting in neurologic deficits. Traditionally, posterior or anterior approaches were used for surgical treatment in the thoracolumbar spine. The mini-open lateral approach for corpectomy in the thoracolumbar spine is relatively new but not yet widely utilized, is less invasive, and is a less morbid surgical option for treating what has historically been a challenging surgical location. A thorough understanding of the anatomy associated with this approach is essential to perform safe and successful surgery with this technique. This review outlines the preoperative and anatomical considerations, surgical technique, contraindications, potential complications, and clinical outcomes associated with performing corpectomies in the thoracolumbar spine via the mini-open lateral approach. This is a safe, successful, and appealing surgical option for appropriately selected patients with diseases of the thoracolumbar region.

Citing Articles

A Cadaver Study: The Relationship of Vital Organs of the Thoracolumbar Junction During a far Lateral Approach Using a T-12 Corpectomy Model.

Lewik G, Pierre C, Hicks J, Rao G, Patel N, Anderson B Global Spine J. 2024; :21925682241299333.

PMID: 39628140 PMC: 11615908. DOI: 10.1177/21925682241299333.

References

Dezawa A, Yamane T, Mikami H, Miki H . Retroperitoneal laparoscopic lateral approach to the lumbar spine: a new approach, technique, and clinical trial. J Spinal Disord. 2000; 13(2):138-43. DOI: 10.1097/00002517-200004000-00008. View

Benner D, Hendricks B, Benet A, Lawton M . Eponyms in Vascular Neurosurgery: Comprehensive Review of 11 Arteries. World Neurosurg. 2021; 151:249-257. DOI: 10.1016/j.wneu.2021.01.115. View

Snyder L, Smith Z, Dahdaleh N, Fessler R . Minimally invasive treatment of thoracic disc herniations. Neurosurg Clin N Am. 2014; 25(2):271-7. DOI: 10.1016/j.nec.2013.12.006. View

Roodman G . Mechanisms of bone metastasis. N Engl J Med. 2004; 350(16):1655-64. DOI: 10.1056/NEJMra030831. View

Uribe J, Smith W, Pimenta L, Hartl R, Dakwar E, Modhia U . Minimally invasive lateral approach for symptomatic thoracic disc herniation: initial multicenter clinical experience. J Neurosurg Spine. 2011; 16(3):264-79. DOI: 10.3171/2011.10.SPINE11291. View

Spiessberger A, Arvind V, Gruter B, Cho S . Thoracolumbar corpectomy/spondylectomy for spinal metastasis: a pooled analysis comparing the outcome of seven different surgical approaches. Eur Spine J. 2019; 29(2):248-256. DOI: 10.1007/s00586-019-06179-8. View

Podet A, Morrow K, Robichaux J, Shields J, DiGiorgio A, Tender G . Minimally invasive lateral corpectomy for thoracolumbar traumatic burst fractures. Neurosurg Focus. 2020; 49(3):E12. DOI: 10.3171/2020.6.FOCUS20366. View

Stillerman C, Chen T, Couldwell W, Zhang W, WEISS M . Experience in the surgical management of 82 symptomatic herniated thoracic discs and review of the literature. J Neurosurg. 1998; 88(4):623-33. DOI: 10.3171/jns.1998.88.4.0623. View

Huangxs S, Christiansen P, Tan H, Smith J, Shaffrey M, Uribe J . Mini-Open Lateral Corpectomy for Thoracolumbar Junction Lesions. Oper Neurosurg (Hagerstown). 2019; 18(6):640-647. DOI: 10.1093/ons/opz298. View

10.

Moskovich R, Benson D, Zhang Z, Kabins M . Extracoelomic approach to the spine. J Bone Joint Surg Br. 1993; 75(6):886-93. DOI: 10.1302/0301-620X.75B6.8245077. View

11.

Pu F, Wang B, Liu J, Chen F, Shao Z . Giant chordoma in the thoracolumbar spine: a case report and literature review. Eur Spine J. 2016; 26(Suppl 1):95-99. DOI: 10.1007/s00586-016-4877-6. View

12.

Algra P, Heimans J, Valk J, Nauta J, Lachniet M, van Kooten B . Do metastases in vertebrae begin in the body or the pedicles? Imaging study in 45 patients. AJR Am J Roentgenol. 1992; 158(6):1275-9. DOI: 10.2214/ajr.158.6.1590123. View

13.

Videman T, Battie M, Gill K, Manninen H, Gibbons L, Fisher L . Magnetic resonance imaging findings and their relationships in the thoracic and lumbar spine. Insights into the etiopathogenesis of spinal degeneration. Spine (Phila Pa 1976). 1995; 20(8):928-35. DOI: 10.1097/00007632-199504150-00009. View

14.

Arce C, Dohrmann G . Herniated thoracic disks. Neurol Clin. 1985; 3(2):383-92. View

15.

Christiansen P, Huang S, Smith J, Shaffrey M, Uribe J, Yen C . Mini-open lateral retropleural/retroperitoneal approaches for thoracic and thoracolumbar junction anterior column pathologies. Neurosurg Focus. 2020; 49(3):E13. DOI: 10.3171/2020.6.FOCUS20360. View

16.

Yen C, Uribe J . Mini-open Lateral Retropleural Approach for Symptomatic Thoracic Disk Herniations. Clin Spine Surg. 2017; 31(1):14-21. DOI: 10.1097/BSD.0000000000000580. View

17.

Siasios I, Vakharia K, Khan A, Meyers J, Yavorek S, Pollina J . Bowel injury in lumbar spine surgery: a review of the literature. J Spine Surg. 2018; 4(1):130-137. PMC: 5911753. DOI: 10.21037/jss.2018.03.10. View

18.

Smith W, Dakwar E, Le T, Christian G, Serrano S, Uribe J . Minimally invasive surgery for traumatic spinal pathologies: a mini-open, lateral approach in the thoracic and lumbar spine. Spine (Phila Pa 1976). 2010; 35(26 Suppl):S338-46. DOI: 10.1097/BRS.0b013e3182023113. View

19.

Fanous A, Lipinski L, Krishna C, Roger E, Siddiqui A, Levy E . The Impact of Preoperative Angiographic Identification of the Artery of Adamkiewicz on Surgical Decision Making in Patients Undergoing Thoracolumbar Corpectomy. Spine (Phila Pa 1976). 2015; 40(15):1194-9. DOI: 10.1097/BRS.0000000000000909. View

20.

Park M, Deukmedjian A, Uribe J . Minimally invasive anterolateral corpectomy for spinal tumors. Neurosurg Clin N Am. 2014; 25(2):317-25. DOI: 10.1016/j.nec.2013.12.009. View