Minimally invasive ventral spondylodesis for injuries of the thoracic and lumbar spine

Thirty-eight patients with 40 fractures of the thoracic spine and the thoracolumbar junction were treated by a minimally invasive procedure, which includes partial corporectomy, the interposition of a tri-cortical bone graft and anterior stabilization by plate spondylodesis under thoracosopic control. For 36 patients the operation was successfully performed in a complete thoracoscopic way; in 2 patients conversion to an open technique was necessary. Two postoperative complications such as a reversible lesion of the thoracodorsalis nerve and a transient irritation of nerve root L1 on the approach side were encountered. Postoperative control by X-ray and CT scan showed correct positioning of the bone graft, as well as the fixation device in all patients. Our experience with this minimally invasive stabilizing procedure for injuries of the thoracic spine and the thoracolumbar junction demonstrated the feasibility of the method. Compared to the open method the benefit of minimally invasive surgery included postoperative pain reduction, shorter hospitalization, early recovery of function and reduced mobidity of the operative approach.