The Transaxillary Approach as a Direct Route in the Management of Upper Thoracic Spine Pathology: A Technical Note with Case Series.

IF 2.3 Q2 ORTHOPEDICS Asian Spine Journal Pub Date : 2024-04-23 DOI:10.31616/asj.2023.0175
S. Ifthekar, Ju-Wan Seuk, Ui Dong Hwang, Hyung-Chang Lee, Sang-Ho Lee, J. Bae
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Abstract

This retrospective case series of prospective data aims to describe the transaxillary approach for the treatment of upper thoracic spine pathology. Various surgical techniques and approaches have been reported across the literature to address upper thoracic spine pathology, including the cervicothoracic approach, anterior transsternal approach, posterolateral approach, supraclavicular approach, and lateral parascapular approaches. These techniques are invasive. A minimally invasive, less morbid, and direct access approach to the pathology of the upper thoracic spine has not been reported in the literature. Patients with pathology affecting the first thoracic vertebra up to the sixth thoracic vertebra were classified into the upper thoracic spine group. Patients with pathology below the sixth thoracic vertebra were excluded. Patients not having a minimum follow-up of 12 months were also excluded. The study analyzed 18 patients. The mean preoperative modified Japanese Orthopedic Association score was 7.2±1.44, which improved to 10.16±1.2 (p<0.05). The majority (14/18) of the patients had an excellent outcome. Three patients had good outcomes, and one patient had a fair outcome. Five cases of intraoperative dural leak were recorded, and one patient had postoperative neurological deficit. The transaxillary approach is a safe, viable, muscle-sparing, and minimally invasive approach for ventral pathologies of the upper thoracic spine.
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经腋窝入路是治疗胸椎上部病变的直接途径:附病例系列的技术说明。
这组回顾性病例系列的前瞻性数据旨在描述经腋窝入路治疗上胸椎病变的方法。文献报道了各种治疗上胸椎病变的手术技术和方法,包括颈胸椎入路、经胸骨前入路、后外侧入路、锁骨上入路和肩胛旁外侧入路。这些技术都是侵入性的。文献中还没有报道过一种微创、发病率较低、直接进入上胸椎的病理学方法。病变影响第一胸椎至第六胸椎的患者被归入上胸椎组。病变在第六胸椎以下的患者被排除在外。随访时间不足 12 个月的患者也被排除在外。研究分析了 18 名患者。术前平均改良日本骨科协会评分为(7.2±1.44)分,术后评分提高到(10.16±1.2)分(P<0.05)。大多数患者(14/18)的疗效极佳。3名患者疗效良好,1名患者疗效一般。5例患者术中出现硬脑膜渗漏,1例患者术后出现神经功能缺损。经腋窝入路是治疗上胸椎腹侧病变的一种安全、可行、不伤肌肉的微创入路。
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来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
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