Minimally Invasive Transpedicular Posterolateral Approach (MITPA) Corpectomy in the Treatment of Traumatic or Metastatic Vertebral Collapse With Kyphosis.

Abstract

Study DesignRetrospective observational cohort study.Vertebral body collapse with subsequent kyphosis, compression of neural structures usually requires surgical treatment; spinal fixation, corpectomy, decompression and realignment of the spine.The objective was to present results of corpectomies using a unilateral minimally invasive posterolateral transpedicular approach (MITPA) in patients with metastatic or posttraumatic kyphosis.Material and MethodsThe study included 28 patients: 23 with osteolytic vertebral body metastases, 5 posttraumatic kyphosis. All patients were operated by 2 surgeons, all had percutaneous pedicle fixation and unilateral single-level corpectomy using MITPA, followed by insertion of an expandable cage. Perioperative parameters were noted and radiological analysis based on CT performed before, after surgery and on the last follow up in 12 months.ResultsThe mean age of patients was 62 years, average length of surgery 263 min, with mean EBL 648 mL and average length of hospital stay 9.3 days. The local kyphosis, measured on end-plates of adjacent vertebrae, was corrected by 14.3° (from 13.1° [±9] to -1.2° [±8], P < .05). Complications occurred in 11 patients (39%), most of them minor, only 2 complications were major (7%): 1 deteriorated neurological deficit and 1 deep vein thrombosis. In 8 cases of preoperative paresis, 7 showed postoperative neurological improvement. In 12 months follow up, no serious mechanical complications were observed, beside minor cage subsidence in 5 cases and adjacent vertebral fracture. The anterior fusion was noted in all cases followed.ConclusionsMITPA corpectomy allows for significant correction of kyphosis, both in metastatic and posttraumatic vertebral body collapse with relatively low rate of major complications.