Minimally Invasive Lateral Retropleural Thoracolumbar Approach: Cadaveric Feasibility Study and Report of 4 Clinical Cases

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons32-ons39 ◽  
Author(s):  
Juan S. Uribe ◽  
Elias Dakwar ◽  
Rafael F. Cardona ◽  
Fernando L. Vale
Keyword(s):  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Early Experience ◽  
Complication Rates ◽  
Minimally Invasive Approach ◽  
Lateral Aspect ◽  
Invasive Approach ◽  
Vertebral Bodies ◽  
Clinical Cases

Abstract BACKGROUND: Traditional anterior and posterior approaches to the thoracolumbar spine are associated with significant morbidity. In an effort to eliminate these drawbacks, minimally invasive retropleural approaches have been developed. OBJECTIVE: To demonstrate the feasibility and clinical experience of a minimally invasive lateral retropleural approach to the thoracolumbar spine. METHODS: Seven cadaveric dissections were performed in 7 fresh specimens to determine the feasibility of the technique. In each specimen, the lateral aspect of the vertebral body was accessed retropleurally, and a corpectomy was performed. Intraprocedural fluoroscopy and postoperative computed tomography were used to assess the extent of decompression. As an adjunct, 3 clinical cases of thoracic fractures and 1 neurofibroma were treated with this minimally invasive approach. Operative results, complications, and early outcomes were assessed. RESULTS: In the cadaveric study, adequate exposure was obtained to perform a lateral corpectomy and to allow interbody grafting between the adjacent vertebral bodies. The procedures were successfully performed in the 4 clinical cases without conversion to conventional approaches. A pleural tear was noted in the first clinical case, and a chest tube was placed without any long-term sequelae. CONCLUSION: Our early experience suggests that the minimally invasive lateral retropleural approach allows adequate vertebrectomy and canal decompression without the tissue disruption associated with posterolateral approaches. This approach may improve the complication rates that accompany open or endoscopic approaches for thoracolumbar corpectomies.

MINIMALLY INVASIVE POSTEROLATERAL THORACIC CORPECTOMY

Neurosurgery ◽  
2009 ◽  
Vol 64 (4) ◽  
pp. 746-753 ◽  
Author(s):  
Dae-Hyun Kim ◽  
John E. O'Toole ◽  
Alfred T. Ogden ◽  
Kurt M. Eichholz ◽  
John Song ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Cancer Metastasis ◽  
Burst Fracture ◽  
Invasive Technique ◽  
Complication Rates ◽  
Minimally Invasive Approach ◽  
Tubular Retractor ◽  
Invasive Approach ◽  
Vertebral Bodies ◽  
Clinical Cases

Abstract OBJECTIVE To demonstrate the feasibility of and initial clinical experience with a novel minimally invasive posterolateral thoracic corpectomy technique. METHODS Seven procedures were performed on 6 cadavers to determine the feasibility of thoracic corpectomy using a minimally invasive approach. The posterolateral thoracic corpectomies were performed with expandable 22 mm diameter tubular retractor paramedian incisions. The posterolateral aspects of the vertebral bodies were accessed extrapleurally, and complete corpectomies were performed. Intraprocedural fluoroscopy and postoperative computed tomography were used to assess the degree of decompression. In addition, 2 clinical cases of T6 burst fracture, 1 T4–T5 plasmacytoma, and 1 T12 colon cancer metastasis were treated using this minimally invasive approach. RESULTS In the cadaveric study, an average of 93% of the ventral canal and 80% of the corresponding vertebral body were removed. The pleura and intrathoracic contents were not violated. Adequate exposure was obtained to allow interbody grafting between the adjacent vertebral bodies. The procedures were successfully performed in the 4 clinical cases using a minimally invasive technique, and the patients demonstrated good outcomes. CONCLUSION Based on this study, minimally invasive posterolateral thoracic corpectomy safely and successfully allows complete spinal canal decompression without the tissue disruption associated with open thoracotomy. This approach may improve the complication rates that accompany open or even thoracoscopic approaches for thoracic corpectomy and may even allow surgical intervention in patients with significant comorbidities.

scholarly journals Relevant Insertion Site Anatomy of the Conventus Distal Radius System

Hand ◽  
2017 ◽  
Vol 13 (3) ◽  
pp. 341-345
Author(s):  
Jacob Duncan ◽  
Marc Trzeciak
Keyword(s):  
Patient Satisfaction ◽  
Minimally Invasive ◽  
Distal Radius ◽  
Kirschner Wire ◽  
Insertion Site ◽  
Minimally Invasive Approach ◽  
Lateral Aspect ◽  
Invasive Approach ◽  
The Mean ◽  
Application Methods

Background: The Conventus Distal Radius System (DRS) is an intramedullary fixation scaffold inserted into the lateral aspect of the distal radius. The purpose of this study was to identify insertion site anatomy to illustrate risks associated with the minimally invasive nature of radial-sided implant application. Methods: Ten cadavers were utilized. Using fluoroscopy, the 1.1-mm Kirschner wire and template was introduced per manufacturer’s guidelines, access guide assembled, and dissection carried out to the superficial radial nerve (SRN) with preservation of the native location. The access guide marked the insertion location for the side-cut drill. This point was measured in relationship to structures nearby, including the SRN, brachioradialis (BR), lateral antebrachial cutaneous nerve (LABCN), and radial styloid (RS). Results: The large guide contacted the SRN in 4 of 10 cadavers and was volar to it in 6 of 10. When volar, the mean distance was 1.7 mm. The tip of the RS to the large access guide averaged 44.5 mm. The small guide contacted the SRN in 2 of 10, was volar to it in 4 of 10, and between the bifurcation in 4 of 10. When volar, the distance averaged 3.25 mm. When bifurcated, the distance from the small guide to both the dorsal and volar branches was 3.5 mm. The distance from the RS to the small guide averaged 37.8 mm. The LABCN was found in the field of dissection in 4 of 10 cadavers. Conclusions: Several structures are at risk during insertion of the Conventus DRS; thus, knowledge of the relevant anatomy of this minimally invasive approach is crucial to optimize outcomes and patient satisfaction, and to avoid nerve injury.

scholarly journals Oxford phase 3 unicondylar knee arthroplasty through a minimally invasive approach: long-term results

2013 ◽  
Vol 37 (5) ◽  
pp. 833-838 ◽  
Author(s):  
Omar Faour-Martín ◽  
Jose Antonio Valverde-García ◽  
Miguel Ángel Martín-Ferrero ◽  
Aurelio Vega-Castrillo ◽  
María Angeles de la Red Gallego ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Knee Arthroplasty ◽  
Unicondylar Knee Arthroplasty ◽  
Long Term Results ◽  
Minimally Invasive Approach ◽  
Phase 3 ◽  
Invasive Approach

Long-Term Outcomes With a Minimally Invasive Approach for Resection of Cardiac Masses

2010 ◽  
Vol 90 (4) ◽  
pp. 1251-1255 ◽  
Author(s):  
Alexander Iribarne ◽  
Rachel Easterwood ◽  
Mark J. Russo ◽  
Jonathan Yang ◽  
Faisal H. Cheema ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Long Term Outcomes ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Cardiac Masses

scholarly journals Calcaneal fractures: a management dilemma-minimally invasive approach for intra and extra articular calcaneal fractures

2019 ◽  
Vol 7 (3) ◽  
pp. 756
Author(s):  
Kawade M. S. ◽  
Madan H. S. ◽  
Shailesh Khachane ◽  
Manjeet Singh Dhanda
Keyword(s):  
Minimally Invasive ◽  
Open Reduction ◽  
Wound Complications ◽  
Walking Ability ◽  
Complication Rates ◽  
Ct Reconstruction ◽  
Minimally Invasive Approach ◽  
Calcaneal Fractures ◽  
Invasive Approach ◽  
Minimally Invasive Methods

Background: Calcaneal fractures which constitutes 2% of total fractures are frequent and very debilitating if not treated properly. Calcaneal fractures generally affect younger population leading to significant man-days loss(around 2-5 years3) and in-turn leading significant economic burden on the society. The goal of treatment for calcaneal fractures is elimination of pain and restoration of normal foot shape, biomechanics, and walking ability. Wound related complications are common with open surgeries. After open reduction internal fixation with perimeter plates for displaced calcaneal fractures, wound edge necrosis is commonly observed with the extended lateral approach. Because of such high incidence of wound complications in open reduction of calcaneum fractures, minimally invasive approach takes priority over open reduction of these fractures.Methods: The study aimed to evaluate the results of minimally invasive approach for calcaneal fractures. To reduce the operative complications, 30 patients were treated with minimally invasive methods in both extra articular and intra-articular calcaneal fractures and the results were evaluated. All patients were evaluated clinically , functionally and radiologically 3D- CT reconstruction images.Results: All cases were followed up for 2 years at specified intervals. The outcome measures were evaluated by AOFAS scores10 with excellent result in 13 cases and good to fair results in the rest. Operated patients had no wound infection, no skin necrosis, 5 patients had mild subtalar arthrosis and 3 patients complained slight difficulty in wearing shoes. None of them have any gait abnormalities.Conclusions: Our study suggests that the minimally invasive methods will reduce the operative complication rates. The minimally invasive surgical intervention in an expert hand can yield better results with less complication rates.

Endovascular repair of profunda femoral artery false aneurysms using covered stents

Vascular ◽  
2011 ◽  
Vol 19 (1) ◽  
pp. 51-54 ◽  
Author(s):  
George N Kouvelos ◽  
Nektarios K Papas ◽  
Eleni M Arnaoutoglou ◽  
George S Papadopoulos ◽  
Miltiadis I Matsagκas
Keyword(s):  
Minimally Invasive ◽  
Femoral Artery ◽  
Endovascular Repair ◽  
False Aneurysm ◽  
Long Term Results ◽  
Covered Stents ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Different Types

Pseudoaneurysms of the profunda femoral artery (PFA) have been reported following different types of trauma, mostly iatrogenic. We present three cases of PFA false aneurysm formation, two after vascular procedures and one as a result of a gunshot injury, which were successfully treated with the endovascular deployment of covered stents. Treating these patients by endoluminal means is an efficient and feasible minimally invasive approach. If the patient is relatively stable and there are no major compression issues, stenting could be considered as adequate therapy for these situations. Certainly, a larger series are needed in order to testify to the long-term results and ascertain the durability of such a repair.

Sign in / Sign up

Export Citation Format

Share Document