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Mini-open transpsoas approach may provide benefits similar to traditional approaches
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Researchers of this retrospective study found patients who underwent a single-level lumbar corpectomy with cage placement through a mini-open, extreme lateral, transpsoas approach supplemented with short-segment posterior instrumentation experienced beneficial outcomes similar to those of a standard, open anterior approach for traumatic burst fractures.
Researchers included 12 patients with unstable lumbar burst fractures who underwent lumbar corpectomies. Each procedure was supplemented with short-segmented posterior instrumentation. All patients had preoperative and postoperative radiographs taken, and the average radiographic follow-up was 37 months.
Preoperative neurological deficits in four patients all improved after surgery, and no new neurological complications were noted in the patient cohort. However, three patients needed chest tube placement for pleural violation. In addition, one patient needed a reoperation for cage subsidence/hardware failure. According to the researchers, preoperative lordosis and kyphosis were both significantly improved in the patient cohort and maintained through final follow-up.
“Patients were satisfied with their outcomes, had minimal disability, and had excellent physical and mental health outcomes after surgery. Our patients’ average functional disability scores are similar to the disability scores reported in the literature (range 5.5 to 20.8) for patients treated operatively for burst fractures. Our patients had minimal pain and good aesthetic results associated with their anterior scar, and thus 89% of patients responded that they would have the same treatment of their spine again given their current results,” researchers wrote in the study.
Researchers concluded the approach is a safe and effective minimally invasive alternative to standard open, anterior approaches. – by Robert Linnehan.
Disclosures: Theologis reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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