naa a22 4500 510760171 CHVBK 20180411083136.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s11420-012-9312-x doi (NATIONALLICENCE)springer-10.1007/s11420-012-9312-x Extreme Lateral Interbody Fusion (XLIF) in the Thoracic and Thoracolumbar Spine: Technical Report and Early Outcomes [Elektronische Daten] [Dennis Meredith, Christopher Kepler, Russel Huang, Vishal Hegde] Background: Previous studies have demonstrated the distinct advantages of thoracoscopically assisted spinal fusion compared to traditional open thoracotomy. However, these techniques are limited by a steep learning curve, prolonged operative time, and lack of three-dimensional visualization of the surgical field. Objective: The objective of this study was to describe our initial experience with an adaptation of the extreme lateral interbody fusion (XLIF) technique allowing access to the anterior aspect of the thoracic and thoracolumbar spine with specific reference to (1) early pulmonary complications, (2) non-pulmonary complications, and (3) ability of this technique to successfully achieve spinal decompression and fusion at the operative level. Methods: Clinical and radiographic data were reviewed for the entire perioperative period. A total of 18 patients (72% females; mean age, 56.8years) underwent a thoracic XLIF procedure for spinal pathologies including disc herniation, fracture, tumor, pseudoarthrosis, and proximal junctional kyphosis. A total of 32 levels were treated, with the majority located at the thoracolumbar junction. Twelve of the procedures were done as part of a combined anterior/posterior surgery. Results: The mean estimated blood loss was 577ml and the mean length of stay was 12days. At a mean follow-up of 14months, all patients except for one (who died of widely metastatic disease) had achieved radiographic evidence of fusion. Two patients developed pulmonary effusions requiring medical intervention. Six patients had seven non-pulmonary complications: incidental durotomy (two), infection (one), instrumentation pullout (one), cardiac arrhythmia (two), and death from metastatic disease (one). Conclusions: The XLIF technique can be utilized for access to the anterior column of the thoracic and thoracolumbar spine. The advantages of this minimally invasive technique include avoidance of the need for an access surgeon and for lung deflation during surgery as well as excellent visualization of the spinal pathology. Hospital for Special Surgery, 2013 spine nationallicence thoracolumbar spine nationallicence XLIF nationallicence lateral access surgery nationallicence Meredith Dennis Spine and Scoliosis Service, Department of Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th St, 10021, New York, NY, USA aut Kepler Christopher Department of Orthopedic Surgery, Thomas Jefferson University Hospital and Rothman Institute, Philadelphia, PA, USA aut Huang Russel Spine and Scoliosis Service, Department of Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th St, 10021, New York, NY, USA aut Hegde Vishal Weill Cornell Medical College, New York, NY, USA aut HSS Journal ® Springer-Verlag 9/1(2013-02-01), 25-31 1556-3316 9:1<25 2013 9 11420 https://doi.org/10.1007/s11420-012-9312-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11420-012-9312-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Meredith Dennis Spine and Scoliosis Service, Department of Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th St, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Kepler Christopher Department of Orthopedic Surgery, Thomas Jefferson University Hospital and Rothman Institute, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Huang Russel Spine and Scoliosis Service, Department of Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th St, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Hegde Vishal Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 773 0- HSS Journal ® Springer-Verlag 9/1(2013-02-01), 25-31 1556-3316 9:1<25 2013 9 11420 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer