A Single Stage Dorsal Corpectomy, Reconstruction and Stabilization; Can We Depend on the Costotransversectomy Approach?

Document Type : Original Articles

Authors

1 Lecturer of Neurosurgery. Department of Neurosurgery. Kafr El-Sheikh University.

2 Department of Neurosurgery. Neurosurgery Department. Alexandria University.

3 Lecturer of Neurosurgery Neurosurgery Department Alexandria Universtity

Abstract

Abstract
Background: Pathologies involving the thoracic spine region may require a 360-degree fusion that is routinely achieved through two separate approaches (anterior and posterior). However, it is time consuming and associated with non-negligible postoperative morbidities. Costotransversectomy approach can effectively achieve circumferential spinal decompression, posterior stabilization, and ventral reconstruction in a single approach with high safety profile.
Aim: To evaluate the efficacy and safety of costotransversectomy approach as a single approach in patients with different thoracic spine pathologies, identifying risk factors for postoperative morbidity.
Materials and Methods: Prospective study of 48 patients with dorsal pathologies managed by costotransversectomy between January 2018, and December 2020. Patients’ demographics, preoperative assessment, operative data, early postoperative complications, and two-years clinical and radiological follow-up will be tabulated and analysed.
Results: 48 patients underwent costotransversectomy for dorsal spinal pathologies. Mean age at presentation was 44 years. Tuberculosis was the most common indication of surgery. Blood loss ranged between 300 and 800 ml, whereas operative time ranged between 120 and 240 minutes. There was a significant improvement in the functional status of patients. Morbidity occurred in nine (18.75%) patients. Old age, diabetes mellitus, and TB were significant risk factors for postoperative morbidity in the univariate analysis, and only diabetes was significant in the multivariate analysis.
Conclusion: Costotransversectomy is safe and effective for the management of patients with thoracic spine disorders in a single setting, achieving favourable clinical and radiological outcome. Diabetes proved to be a significant risk factor associated with increased postoperative morbidity in a multivariate analysis.

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