Extended costotransversectomy to achieve circumferential fusion for pathologies causing thoracic instability

Area of Science:

• Spine surgery
• Orthopedic surgery
• Neurosurgery

Background:

• Conventional thoracic spine stabilization often requires multi-stage procedures.
• This study introduces a single-stage approach for complex thoracic spine instability.

Purpose of the Study:

• To achieve neural canal decompression, pathology removal, and circumferential fusion in one stage.
• To correct thoracic spine deformity using a novel surgical technique.

Main Methods:

• A prospective, observational study of 46 patients with pan thoracic column instability.
• Utilized an extended costotransversectomy approach for single-stage circumferential fusion, including pedicle screw and cage fixation.
• Assessed neurologic status using American Spinal Injury Association and Eastern Cooperative Oncology Group grading systems.

Main Results:

• The primary pathologies included trauma (21) and tuberculosis (18).
• 76% of patients showed improved performance status post-surgery.
• Major complications included pneumonitis, pneumothorax, and neurologic deterioration in a small percentage of patients.

Conclusions:

• The extended costotransversectomy approach is a viable option for single-stage circumferential fusion in the thoracic spine.
• This technique effectively corrects instability from both traumatic and non-traumatic causes.