Thoracoscopically assisted ligamentous release of the thoracic spine: a cadaver study

被引:3
作者
Birnbaum, K [1 ]
Pieper, S
Prescher, A
Siebert, CH
机构
[1] Aachen Tech Univ, Univ Hosp, Dept Orthoped, Aachen, Germany
[2] Aachen Tech Univ, Inst Anat, D-52074 Aachen, Germany
关键词
spine; thoracic spine; hyperkyphosis; anterior longitudinal ligament; thoracoscopy; anatomy;
D O I
10.1007/s00276-000-0143-y
中图分类号
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号
100101 [人体解剖与组织胚胎学];
摘要
The surgical treatment of thoracic kyphosis frequently requires an anterior release, which can be carried out by an open or endoscopic technique. This study concerns the reference points which are essential from the anatomic view for minimizing the operative risks. Furthermore we wanted to find the most convenient video-assisted thoracoscopic surgery (VATS) technique for transection of the anterior longitudinal ligament (ALL). Transection of the ALL, as well as discectomy, was performed using this technique. The extensive anatomic dissection of 12 fresh cadavers was performed to define possible technical errors and surgical complications. The development of new instruments has made the VATS approach to the ALL a viable alternative to open procedures. With the help of a standardized technique, the isolated thoracoscopic ligamentous transection required less time than the comparable open procedure. The anatomic study showed, that in no case was a ligation of the intercostal or segmental vessels necessary as part of the approach to the spine, once an adequate mobilization of the esophagus and azygos vein had been carried out. The risk of an ischemic lesion of the spinal cord was thereby reduced. The thoracoscopic, limited anterior release consisting of a multilevel transection of the ALL proved to be a rapid and reliable procedure. Our anatomic studies provides suitable the reference points.
引用
收藏
页码:143 / 150
页数:8
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