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DOI: 10.1055/s-2008-1038877
© Georg Thieme Verlag KG Stuttgart · New York
Thoracotomy in Spine Surgery
Publication History
received April 21, 2008
Publication Date:
14 November 2008 (online)
Abstract
Objective: Aim of the study was the assessment of thoracotomies performed for spine surgery.
Methods: All patients undergoing spine surgery with thoracotomy between December 2004 and October 2007 were included and evaluated with regard to their age, gender, etiology, the level of the intervention and the types of procedures performed.
Results: A total of 29 patients undergoing spine surgery were included. Mean age was 45 years (range: 6–75) and the female to male ratio was 9 : 20. Trauma (14 patients, 48 %) and malignancy (5 patients, 17 %) were the most frequent reasons for surgery. A total of 7, 8 and 14 patients were operated at T3–T6, T7–T10, and T11–L2 levels, respectively. A left thoracotomy was performed in all but three patients (n = 26). The most frequent procedure was corpectomy and stabilization (n = 25, 86 %).
Conclusion: An anterior approach with thoracotomy is needed for spine surgery in subjects with conditions such as lung cancer, trauma, hydatid cyst, etc. A good preoperative assessment of the vertebrae requiring intervention and the use of appropriate techniques for separating the diaphragm during thoracotomy may provide a good exposure up to the L3 level.
Key words
anterior approach - spine surgery - thoracotomy
References
- 1 Hitchon P W, Tomer J, Eichholz K M, Beeler S M. Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures. J Neurosurg Spine. 2006; 5 117-125
- 2 Schnee C L, Ansell L V. Selection criteria and outcome of operative approaches for thoracolumbar burst fractures with and without neurological deficit. J Neurosurg. 1997; 86 48-55
- 3 Muschik M T, Kimmich H, Demmel T. Comparison of anterior and posterior double-rod instrumentation for thoracic idiopathic scoliosis: results of 141 patients. Eur Spine J. 2006; 11 28-38
- 4 Dai L Y, Jiang S D, Wang X Y, Jiang S Y. A review of the management of thoracolumbar burst fractures. Surg Neurol. 2007; 67 221-231
- 5 Denis F, Amstrong G W, Searls K, Matta L. Acute thoracolumbar burst fractures in the absence of neurologic deficit: a comparison between operative and nonoperative treatment. Clin Orthop. 1984; 189 142-149
- 6 Liljengvist U R, Bullmann V, Schulte T L, Hackenverg L, Halm H F. Anterior dual rod instrumentation in idiopathic scoliosis. Eur Spine J. 2006; 15 1118-1127
- 7 Levin R, Matusz D, Hasharoni A, Scharf C, Lonner B, Errico T. Mini-open thoracoscopically assisted thoracotomy versus video-assisted thoracoscopic surgery for anterior release in thoracic scoliosis and kyphosis: a comparison of operative and radiographic results. Spine J. 2005; 5 632-638
- 8 Jochen S H, Laurel B, Connie P K, George T. Video assisted thoracoscopic surgery in idiopathic scoliosis: evaluation of the learning curve. Spine. 2007; 32 703-707
- 9 Gurelik M, Goksel H M, Nadir A. Posterior mediastinal paravertebral hydatid cyst causing severe paraparesis. Br J Neurosurg. 2002; 16 605-606
Dr. Aydin Nadir
Cumhuriyet University
Department of Thoracic Surgery
Cumhuriyet Üniversitesi, Týp Fakültesi, Göðüs Cerrahisi
58141 Sivas
Turkey
Phone: + 90 34 62 58 02 11
Fax: + 90 34 62 58 13 05
Email: anadir@ttmail.com