TY - JOUR
T1 - The extreme lateral approach for treatment of thoracic and lumbar vertebral body metastases
AU - Serak, John
AU - Vanni, Steven
AU - Levi, Allan D
PY - 2019/8/1
Y1 - 2019/8/1
N2 - In addition to radiotherapy, the utility of surgical decompression and stabilization in patients with metastatic vertebral body tumors causing cord compression, progressive deformity and/or intractable pain has been well demonstrated. Minimally invasive approaches are an attractive alternative to traditional procedures as they may reduce the degree of disruption of normal anatomy, decrease blood loss, shorten hospital stays and reduce the risk of infection or wound dehiscence. The extreme lateral approach is a procedure that provides access to the anterior spine through a small incision along the flank utilizing a unique retractor system without disruption of posterior vertebral elements, spinal musculature and ligaments. A review of two senior surgeons' databases was performed between June 2010 and October 2014 to identify patients with metastatic vertebral body tumors who were treated surgically at the University of Miami during this period. We report the results of eight cases in which the extreme lateral approach was employed to perform a corpectomy and cage reconstruction for metastatic disease of the thoracic and lumbar vertebral bodies. Each case was supplemented by posterior percutaneous or less commonly open pedicle screw instrumentation. Postoperative imaging demonstrated excellent decompression of neural elements as well as deformity correction, and all patients maintained or improved neurologic function. There were no instances of wound dehiscence or infection. Our results indicate that the extreme lateral approach can be effectively used to excise metastatic vertebral body lesions of the thoracolumbar spine causing spinal cord and/or nerve root compression and spinal deformity.
AB - In addition to radiotherapy, the utility of surgical decompression and stabilization in patients with metastatic vertebral body tumors causing cord compression, progressive deformity and/or intractable pain has been well demonstrated. Minimally invasive approaches are an attractive alternative to traditional procedures as they may reduce the degree of disruption of normal anatomy, decrease blood loss, shorten hospital stays and reduce the risk of infection or wound dehiscence. The extreme lateral approach is a procedure that provides access to the anterior spine through a small incision along the flank utilizing a unique retractor system without disruption of posterior vertebral elements, spinal musculature and ligaments. A review of two senior surgeons' databases was performed between June 2010 and October 2014 to identify patients with metastatic vertebral body tumors who were treated surgically at the University of Miami during this period. We report the results of eight cases in which the extreme lateral approach was employed to perform a corpectomy and cage reconstruction for metastatic disease of the thoracic and lumbar vertebral bodies. Each case was supplemented by posterior percutaneous or less commonly open pedicle screw instrumentation. Postoperative imaging demonstrated excellent decompression of neural elements as well as deformity correction, and all patients maintained or improved neurologic function. There were no instances of wound dehiscence or infection. Our results indicate that the extreme lateral approach can be effectively used to excise metastatic vertebral body lesions of the thoracolumbar spine causing spinal cord and/or nerve root compression and spinal deformity.
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U2 - 10.23736/S0390-5616.16.03358-X
DO - 10.23736/S0390-5616.16.03358-X
M3 - Article
C2 - 26337129
AN - SCOPUS:85068417860
VL - 63
SP - 473
EP - 478
JO - Journal of Neurosurgical Sciences
JF - Journal of Neurosurgical Sciences
SN - 0026-4881
IS - 4
ER -