Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Apr 2014
Review Comparative StudyMinimally invasive transforaminal lumbar interbody fusion (MI-TLIF): surgical technique, long-term 4-year prospective outcomes, and complications compared with an open TLIF cohort.
Transforaminal lumbar interbody fusion (TLIF) is an important surgical option for the treatment of back pain and radiculopathy. The minimally invasive TLIF (MI-TLIF) technique is increasingly used to achieve neural element decompression, restoration of segmental alignment and lordosis, and bony fusion. This article reviews the surgical technique, outcomes, and complications in a series of 144 consecutive 1- and 2-level MI-TLIFs in comparison with an institutional control group of 54 open traditional TLIF procedures with a mean of 46 months' follow-up. The evidence base suggests that MI-TLIF can be performed safely with excellent long-term outcomes.
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Neurosurg. Clin. N. Am. · Apr 2014
ReviewLateral transpsoas lumbar interbody fusion: outcomes and deformity correction.
The lateral transpsoas approach for interbody fusion is a minimally invasive technique that has been gaining increasing popularity in the management of a variety of spinal degenerative disorders. Recently, there has been increasing utilization of this technique in the management of adult deformity. The authors present a review of the current evidence of using the lateral lumbar transpsoas approach in the correction of adult degenerative scoliosis.
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Neurosurg. Clin. N. Am. · Apr 2014
ReviewMiniopen pedicle subtraction osteotomy: surgical technique and initial results.
As minimally invasive surgery (MIS) has advanced to treat diverse diseases, there has been an increasing need for MIS surgery to be able to restore lumbar lordosis and treat sagittal balance abnormalities. In this article, the surgical technique and initial clinical and radiographic outcomes with a new miniopen pedicle subtraction osteotomy technique are outlined. Combining the MIS techniques of interbody fusion, percutaneous screw fixation, and facet fusion with a selective opening for the osteotomy site allows for safe and efficient deformity corrections. This technique resulted in an average increase of 29.2° of lumbar lordosis (range 17°-44°).
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Neurosurg. Clin. N. Am. · Apr 2014
ReviewMinimally invasive extracavitary transpedicular corpectomy for the management of spinal tumors.
Management of spinal metastasis is a large and challenging clinical problem. For metastatic epidural spinal cord compression, a prospective, randomized, controlled trial showed the utility of circumferential surgical decompression followed by adjuvant radiotherapy. ⋯ The transpedicular approach has recently been modernized with minimally invasive and mini-open techniques. This article presents the relevant clinical background on spinal metastasis, reviews the surgical technique for minimally invasive transpedicular corpectomy, and finally reviews relevant results in the literature.
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Neurosurg. Clin. N. Am. · Apr 2014
ReviewEvidence basis/outcomes in minimally invasive spinal scoliosis surgery.
Traditional adult scoliosis surgery is associated with long-term patient improvement in clinical and radiographic outcome measures, significant blood loss, and high likelihood of medical complications. Because the patient population undergoing adult scoliosis surgery is often elderly with medical comorbidities, minimally invasive spinal surgery (MISS) for adult scoliosis is theoretically appealing, because it is associated with less tissue trauma and reduced blood loss. ⋯ MISS scoliosis correction is reviewed, specifically regarding outcomes and complications. Limitations of current techniques and future directions are discussed.