Journal de la colonne vertébrale

Long Thoracic and Lumbar Spinal Stabilization with a Minimally Invasive Spine Surgery Technique

Abstract

Hiroshi Kuroki, Naoki Inomata, Hideaki Hamanaka and Etsuo Chosa

Objectives: The purpose of the current case presentation was to indicate the usefulness of long thoracic and lumbar (TL) spinal stabilization by percutaneous minimally invasive instrumentation.

Materials and Methods: From August 2012 to May 2013, we performed long TL spinal stabilization with VIPER 2 system (Depuy Spine, Inc., MA, US) by using a minimally invasive surgery (MIS) posterior approach in 4 patients. The first case was a 54 year old male who suffered from burst fracture of T12 (Frankel A) with brain contusion by a fall. The second case was a 68 year old male who developed incomplete paraplegia by metastatic renal cell carcinoma of T11 (Frankel C). The third case was a 79 year old male who affected Chance fracture of T12 (Frankel E) with an ankylosing spinal hyperostosis. And the fourth case was a 75 year old male who sustained pathological fracture of T8 (Frankel A) due to metastasis of prostatic carcinoma accompanied by an ankylosing spinal hyperostosis. The assessment included the clinical outcome of the patients and implant imaging evaluation.

Results: Physical function was improved in all cases with quick pain relief. Mean operative time was 204 minutes. Mean estimated blood loss was 62.5 ml. In radiographic evaluation, spinal alignment was successfully maintained. One pedicle screw in case 3 cut out laterally in a pedicle-rib unit, but other pedicle screws in all cases were correctly inserted. No implant related complication was observed. And there were no conversions to open surgery.

Discussion: In comparison with conventional open surgery, intraoperative blood loss, operative time, and postoperative pain were remarkably decreased in a MIS technique. Long TL spinal stabilization with a MIS technique is useful method for the patients who are desirable to avoid major surgical procedure.