Unilateral Minimally Invasive Across-Midline Vertebral Column Resection Partially Corrects Thoracolumbar Kyphosis - A Case Series

World Neurosurg. 2023 Oct:178:e394-e402. doi: 10.1016/j.wneu.2023.07.078. Epub 2023 Jul 22.

Abstract

Objective: The goal of this study was to describe the indirect and partial correction of spine kyphotic deformities (secondary to various pathologies) achieved by minimally invasive posterolateral extracavitary approach (MIS PLECA) for corpectomy.

Methods: The authors retrospectively reviewed a consecutive case series of 12 patients undergoing MIS PLECA in a single institution. Perioperative data were collected and follow-up computed tomographies and radiographs were reviewed to assess for interbody arthrodesis.

Results: The mean age was 60.7 ± 20.8 years (58.4% males). The etiologies of deformity included pathological fracture (41.6%), acute trauma (30%), and infection. An expandable cage was used in 66.7% of patients for anterior reconstruction. The mean total estimated blood loss was 764.1 ± 332.9 ml. The mean operative time was 413.3 ± 98.8 minutes. The average length of hospital stay was 5.8 ± 2.5 days. A consistent degree of focal correction of sagittal alignment was seen in all patients with a mean correction of sagittal angle of 7.4 ± 4.3° (P < 0.0001). The mean duration of rehabilitation was 8.5 ± 6.7 days. All patients remained neurologically stable at the last follow-up with a mean follow-up period of 20.1 ± 12.8 months. Successful fusion was achieved in 91.7% at the last follow-up.

Conclusions: MIS PLECA for corpectomy appears to be a feasible, safe, and effective MIS technique for select patients, particularly those who cannot tolerate the traditional open approach. Additionally, a focal sagittal deformity correction can be achieved using MIS corpectomy.

Keywords: Angle correction; MIS PLECA; MIS spine; Minimally invasive spine surgery; Posterolateral extracavitary approach; Sagittal imbalance; Spine deformity surgery.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Kyphosis* / diagnostic imaging
  • Kyphosis* / surgery
  • Lumbar Vertebrae* / diagnostic imaging
  • Lumbar Vertebrae* / surgery
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures* / methods
  • Retrospective Studies
  • Spinal Fusion / methods
  • Thoracic Vertebrae* / diagnostic imaging
  • Thoracic Vertebrae* / surgery
  • Treatment Outcome