• Pietro Domenico Giorgi, Simona Legrenzi, Lorenzo Sacchi, Davide Boeris, Fabio Giuseppe Villa, Federico Bove, Francesco Puglia, and Giuseppe Rosario Schirò.
• Orthopedics and Traumatology Unit, Emergency and Urgency Department, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy.
• World Neurosurg. 2024 Apr 1; 184: 232823-28.

AbstractThe development and diffusion of minimally invasive (MI) approaches have coincided with improvements in magnification systems. The exoscope will probably open a new era in new technologies in spinal surgery. This study reports a retrospective series of 19 thoracolumbar (T11-L2) burst fractures with anterior column failure and cord compression, treated with MI corpectomy and spinal decompression assisted by a three-dimensional high-definition exoscope (Video 1). Exclusion criteria were pathologic or osteoporotic fractures, multilevel fractures, and previous surgery at the site of the fracture. Three key indicators were recorded: surgical time, blood loss, and intraoperative complications. A questionnaire was administered to assess the users' exoscope experience with ergonomics, preparation, magnification, image definition, illumination, and user-friendliness, compared with the operative microscope. To the best of our knowledge, this is the first study reporting on exoscope-assisted MI corpectomy. This procedure permitted low blood loss and less surgical time without intraoperative complications. The exoscope offers clear advantages in terms of ergonomics, definition, and user-friendliness. Moreover, it is a suitable instrument for training and education, providing an opportunity for better interaction with other members of the surgical staff.Copyright © 2024 Elsevier Inc. All rights reserved.

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