Revista de la Asociación Argentina de Ortopedia y Traumatología
versión On-line ISSN 1852-7434
NOEL, Mariano A. et al. Posterior thoracotomy: A two-step, one incision thoracic spinal approach; Evaluation of 35 cases. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.3, pp. 263-267. ISSN 1852-7434.
Background: Over the last 7 years, for patients who needed a combined anterior-posterior approach, we have used an alternative thoracotomy through a posterior approach using the same posterior mid-line skin incision for both the first and second step. Our purpose was to assess the possibilities and complications associated with an approach that allows to combine a two-step surgery through a single posterior skin incision. Methods: We retrospectively evaluated 35 patients operated between 2003 and 2007. In all patients a two-step approach through a single posterior mid-line skin incision was used for spinal cord decompression, discectomy, arthrodesis, osteotomy, or vertebrectomy. The following were evaluated: angle magnitudes, etiology, age, vertebral levels; number of thoracotomies, and complications Results: Mean age 14.1 years (1-65years). Ten kyphoses and 24 kyphoscoliosis. Mean scoliosis was 80.5°(60°- 105°), mean kyphosis was 96.8° (76°-131°). Etiology: genetic syndromes 11, Idiopathic scoliosis 6, neurological 5, congenital 4, fractures 2, disc herniation 1, tumors 4, and infection 2. Thoracotomy was single in 30 and double in 5, the highest at T3 level and the lowest at T10. Complications: one pleural hemorrhage and 2 posterior surgical wound infections (8.6%). Conclusions: This approach allows access to all thoracic levels in combined procedures through a single posterior skin incision.
Palabras clave : Upper thorax; Double approach; Posterior thoracotomy; Complications; Single incision.