Attending CIEN (Center for Research and Training in Neurosurgery) Bogota, Colombia
Introduction: Thoracolumbar fractures (TLF) often course with instability or neurological deficit requiring early surgical treatment. Mini-open lateral corpectomy (MOLC) allows for spine decompression along with anterior spine reconstruction through a minimally invasive approach. We reported our experience using MOLC for TLF.
Methods: We reviewed our prospectively maintained spine trauma database at two referral institutions between 2014 and 2023. From a total of 2428 patients with traumatic spine injuries, we identified 18 consecutive patients who underwent a MOLC. Demographic, operative, and clinical outcome data were recorded from electronic medical charts.
Results: Eighteen patients (12 males, median age of 46 years) underwent 17 single-level and 1 two-level mini-open lateral corpectomies. At a median follow-up of 12 months (range, 3.0-55.5), symptom control and enhanced quality of life were achieved in all patients. The mean VAS score fall was 4.75 [CI 95%, 4.14-5.6] (p < 0.001), and the mean ODI improved from 63.7% to 14.4% (p < 0.001) after surgery. All patients with neurological deficits improved after intervention (p=0.03). The mean vertebral height improvement was 8.00 [CI 95%, 3.27-12.72] (p=0.003) and the mean segmental kyphosis reduction was 1.74° [CI 95%, -2.18-5.67] (p=0.160) after spinal reconstruction. Minor complications were identified in 4 patients, one patient had a pleural violation and three patients developed transient intercostal neuralgia.
Conclusion : The mini-open lateral corpectomy is a safe and effective less invasive technique for patients with an unstable TLF or with neurological compromise. In spite of an initial steep learning curve, a mini-open lateral approach is a feasible option for ventral spine reconstruction.
