Mini-open transpedicular corpectomies with expandable cage reconstruction

Technical note

Dean Chou M.D. and Daniel C. Lu M.D., Ph.D.
View More View Less
  • Department of Neurosurgery, University of California, San Francisco, California
Restricted access

Purchase Now

USD  $45.00

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

Transpedicular corpectomies are frequently used to perform anterior surgery from a posterior approach. Minimally invasive thoracolumbar corpectomies have been previously described, but these are performed through a unilateral approach. Bilateral access must be obtained for a circumferential decompression when using such techniques. The authors describe a technique that allows for a mini-open transpedicular corpectomy, 360° decompression, and expandable cage reconstruction through a single posterior approach. This is performed using percutaneous pedicle screws, the trap-door rib-head osteotomy, and a single midline fascial exposure. The authors describe this technique with intraoperative photos and a video demonstrating the technique.

Abbreviation used in this paper: PLL = posterior longitudinal ligament.

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Current affiliation for Dr. Lu: Department of Neurosurgery, University of California, Los Angeles, California.

Address correspondence to: Dean Chou, M.D., Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Box 0112, San Francisco, California 94143-0112. email: choud@neurosurg.ucsf.edu.

Please include this information when citing this paper: published online December 17, 2010; DOI: 10.3171/2010.10.SPINE091009.

  • 1

    Akeyson EW, & McCutcheon IE: Single-stage posterior vertebrectomy and replacement combined with posterior instrumentation for spinal metastasis. J Neurosurg 85:211220, 1996

    • Search Google Scholar
    • Export Citation
  • 2

    Bilsky MH, , Boland P, , Lis E, , Raizer JJ, & Healey JH: Single-stage posterolateral transpedicle approach for spondylectomy, epidural decompression, and circumferential fusion of spinal metastases. Spine 25:22402250, 2000

    • Search Google Scholar
    • Export Citation
  • 3

    Chou D, , Eltgroth M, , Yang I, , Lu D, & Manley G: Rib head disarticulation for multilevel transpedicular thoracic corpectomies and expandable cage reconstruction. Neurol India 57:469474, 2009

    • Search Google Scholar
    • Export Citation
  • 4

    Chou D, , Lu D, , Chi J, & Wang V: Rib-head osteotomies for posterior placement of expandable cages in the treatment of metastatic thoracic spine tumors. J Clin Neurosci 15:10431047, 2008

    • Search Google Scholar
    • Export Citation
  • 5

    Chou D, & Wang VY: Trap-door rib-head osteotomies for posterior placement of expandable cages after transpedicular corpectomy: an alternative to lateral extracavitary and costotransversectomy approaches. Technical note. J Neurosurg Spine 10:4045, 2009

    • Search Google Scholar
    • Export Citation
  • 6

    Chou D, , Wang VY, & Gupta N: Transpedicular corpectomy with posterior expandable cage placement for L1 burst fracture. J Clin Neurosci 16:10691072, 2009

    • Search Google Scholar
    • Export Citation
  • 7

    Dai LY, , Jiang LS, & Jiang SD: Posterior short-segment fixation with or without fusion for thoracolumbar burst fractures. a five to seven-year prospective randomized study. J Bone Joint Surg Am 91:10331041, 2009

    • Search Google Scholar
    • Export Citation
  • 8

    Deutsch H, , Boco T, & Lobel J: Minimally invasive transpedicular vertebrectomy for metastatic disease to the thoracic spine. J Spinal Disord Tech 21:101105, 2008

    • Search Google Scholar
    • Export Citation
  • 9

    Gokaslan ZL, , York JE, , Walsh GL, , McCutcheon IE, , Lang FF, & Putnam JB Jr, : Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg 89:599609, 1998

    • Search Google Scholar
    • Export Citation
  • 10

    Hunt T, , Shen FH, & Arlet V: Expandable cage placement via a posterolateral approach in lumbar spine reconstructions. Technical note. J Neurosurg Spine 5:271274, 2006

    • Search Google Scholar
    • Export Citation
  • 11

    Kim DH, , O'Toole JE, , Ogden AT, , Eichholz KM, , Song J, & Christie SD, : Minimally invasive posterolateral thoracic corpectomy: cadaveric feasibility study and report of four clinical cases. Neurosurgery 64:746753, 2009

    • Search Google Scholar
    • Export Citation
  • 12

    Musacchio M, , Patel N, , Bagan B, , Deutsch H, , Vaccaro AR, & Ratliff J: Minimally invasive thoracolumbar costotransversectomy and corpectomy via a dual-tube technique: evaluation in a cadaver model. Surg Technol Int 16:221225, 2007

    • Search Google Scholar
    • Export Citation
  • 13

    Shaw B, , Mansfield FL, & Borges L: One-stage posterolateral decompression and stabilization for primary and metastatic vertebral tumors in the thoracic and lumbar spine. J Neurosurg 70:405410, 1989

    • Search Google Scholar
    • Export Citation
  • 14

    Shen FH, , Marks I, , Shaffrey C, , Ouellet J, & Arlet V: The use of an expandable cage for corpectomy reconstruction of vertebral body tumors through a posterior extracavitary approach: a multicenter consecutive case series of prospectively followed patients. Spine J 8:329339, 2008

    • Search Google Scholar
    • Export Citation
  • 15

    Snell BE, , Nasr FF, & Wolfla CE: Single-stage thoracolumbar vertebrectomy with circumferential reconstruction and arthrodesis: surgical technique and results in 15 patients. Neurosurgery 58:4 Suppl 2 ONS-263ONS-269, 2006

    • Search Google Scholar
    • Export Citation
  • 16

    Wang JC, , Boland P, , Mitra N, , Yamada Y, , Lis E, & Stubblefield M, : Single-stage posterolateral transpedicular approach for resection of epidural metastatic spine tumors involving the vertebral body with circumferential reconstruction: results in 140 patients. J Neurosurg Spine 1:287298, 2004

    • Search Google Scholar
    • Export Citation
  • 17

    Wang ST, , Ma HL, , Liu CL, , Yu WK, , Chang MC, & Chen TH: Is fusion necessary for surgically treated burst fractures of the thoracolumbar and lumbar spine? A prospective, randomized study. Spine 31:26462653, 2006

    • Search Google Scholar
    • Export Citation
  • 18

    Wiggins GC, , Mirza S, , Bellabarba C, , West GA, , Chapman JR, & Shaffrey CI: Perioperative complications with costotransversectomy and anterior approaches to thoracic and thoracolumbar tumors. Neurosurg Focus 11:6 e4, 2001

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 576 356 8
Full Text Views 146 33 6
PDF Downloads 160 24 2
EPUB Downloads 0 0 0