Anterior Cervical Incision and Thoracotomy for Cervico-thoracic, Thoracic, and Thoracolumbar Spine Surgery: A Clinical Series | ||
| Journal of Cardio-Thoracic Medicine | ||
| مقاله 4، دوره 4، شماره 4، اسفند 2016، صفحه 513-515 اصل مقاله (761.09 K) | ||
| نوع مقاله: Original Article | ||
| شناسه دیجیتال (DOI): 10.22038/jctm.2016.7878 | ||
| نویسندگان | ||
| Seyyed Hossein Fattahi Masoom1؛ Babak Ganjeifar* 2 | ||
| 1Thoracic Surgeon, Cardio-Thoracic Surgery & Transplant Research Center,Mashhad University of Medical Sciences, Mashhad, Iran. | ||
| 2Neurological Surgeon, Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran | ||
| چکیده | ||
| Introduction:Surgical treatment of diseases in cervicothoracic, thoracic and thoracolumbar regions can be a challenging issue. Cooperation of the thoracic surgeons and spine surgeons can improve the outcomes and decrease the complications of patients who underwent these approaches. Materials & Methods: The participants of this study consisted of seventeenpatients suffering from different types of vertebral lesions such as spinal TB, primary tumor, metastasis, and scoliosis. These patients were operated through anterior lower cervical incision (without sternotomy), standard thoracotomy, and lower thoracotomy during 2001-2016. For five patients, exposure of cervicothoracic region was achieved through anterior cervical incision with extension to anterior chest wall (without sternotomy). Through performing posterolateral thoracotomy (left or right) on nine patients, spine surgeons had a better access to the vertebral pathologies. In three cases, a perfect access to the thoracoabdominal spine was obtained by performing lower thoracotomy with removal of the twelfth rib and release of diaphragm from the chest wall. Results: In total, seventeen patients [eleven males (65%) and 6 (35%) females] with the mean age of 33.6 ± 19.4 were operated. 6 (35%) patients suffered from cervicothoracic lesions, 8 (47%)cases had lesions in middle and lower thoracic spine, and 3 (18%) patients had lesion in the thoracolumbar vertebra. Postoperatively, no mortality was observed in the patients and complications were reported to be minimal. Conclusion: According to the findings, the joint corporation of thoracic and spine surgeons can improve exposure of cervicothoracic, thoracic, and thoracolumbar regions. Furthermore, this approach can decrease the complications of these complex surgeries. | ||
| کلیدواژهها | ||
| Thoracotomy؛ Surgical Incisions؛ Spine Vertebral Column | ||
| مراجع | ||
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1.Le H, Balabhadra R, Park J, Kim D. Surgical treatment of tumors involving the cervicothoracic junction. Neurosurg Focus. 2003; 15:1-7. 2.Boyle JJ, Singer KP, Milne N. Morphological survey of the cervicothoracic junctional region. Spine. 1996; 21:544-8.
3.Schuchert MJ, McCormick KN, Abbas G, Pennathur A, Landreneau JP, Landreneau JR, et al. Anterior thoracic surgical approaches in the treatment of spinal infections and neoplasms. Ann Thorac Surg. 2014; 97:1750-6.
4.Boockvar JA, Philips MF, Telfeian AE, O'Rourke DM, Marcotte PJ. Results and risk factors for anterior cervicothoracic junction surgery. J Neurosurg. 2001; 94:12-7.
5.Pimenta L, Smith W, Taylor W, Uribe J. Lateral access surgery for the thoracolumbar spine. Sci World J. 2013; 2013:2417056.
6.McCormick PC. Retropleural approach to the thoracic and thoracolumbar spine. Neurosurg. 1995; 37:908-14.
7.Ravindra VM, Brock A, Awad AW, Kalra R, Schmidt MH. The role of the mini-open thoracoscopic-assisted approach in the management of metastatic spine disease at the thoracolumbar junction. Neurosurg Focus. 2016; 41:E16.
8.Nazzaro JM, Arbit E, Burt M. "Trap door" exposure of the cervicothoracic junction.Technical note. J Neurosurg. 1994; 80:338-41.
9. Darling GE, McBroom R, Perrin R. Modified anterior approach to the cervicothoracic junction. Spine. 1995; 20:1519-21.
10. Gieger M, Roth PA, Wu JK. The anterior cervical approach to the cervicothoracic junction. Neurosurgery. 1995; 37:704-9.
11. Birch R, Bonney G, Marshall RW. A surgical approach to the cervicothoracic spine. J Bone Joint Surg Br. 1990; 72:904-7.
12. McDonald P, Letts M, Sutherland G, Unruh H. Aneurysmal bone cyst of the upper thoracic spine. An operative approach through a manubrial sternotomy. Clin Orthop Relat Res. 1992; 279:127-32.
13. Luk KD, Cheung KM, Leong JC. Anterior approach to the cervicothoracic junction by unilateral or bilateral manubriotomy. A report of five cases. J Bone Joint Surg Am. 2002; 84-A:1013-7.
14. Nadir A, Sahin E, Ozum U, Karadag O, Tezeren G, Kaptanoglu M. Thoracotomy in spine surgery. Thorac Cardiovasc Surg. 2008; 56:482-4.
15. Hott JS, Feiz-Erfan I, Kenny K, Dickman CA. Surgical management of giant herniated thoracic discs: analysis of 20 cases. J Neurosurg Spine. 2005; 3:191-7.
16. Gokaslan ZL, York JE, Walsh GL, McCutcheon IE, Lang FF, Putnam JB Jr, et al. Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg. 1998; 89:599-609.
17. Krasna MJ, Jiao X, Eslami A, Rutter CM, Levine AM. Thoracoscopic approach for spine deformities. J Am Coll Surg. 2003; 197:777-9.
18. Khoo LT, Smith ZA, Asgarzadie F, Barlas Y, Armin SS, Tashjian V, et al. Minimally invasive extracavitary approach for thoracic discectomy and interbody fusion: 1-year clinical and radiographic outcomes in 13 patients compared with a cohort of traditional anterior transthoracic approaches. J Neurosurg Spine. 2011; 14:250-60.
19. Fessler RG, Sturgill M. Review: complications of surgery for thoracic disc disease. Surg Neurol. 1998; 49:609-18.
20. McCormick WE, Will SF, Benzel EC. Surgery for thoracic disc disease. Complication avoidance: overview and management. Neurosurg Focus. 2000; 9:e13.
21. Snyder LA, Smith ZA, Dahdaleh NS, Fessler RG. Minimally invasive treatment of thoracic disc herniations. Neurosurg Clin N Am. 2014; 25:271-7.
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