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Novel Bilateral Extracavitary Approach for Thoracolumbar Decompression
Jeffrey P Mullin1, Alvin Y Chan1, Emily Bennett1
1Department of Neurosurgery, Cleveland Clinic, Neurological Institute, Cleveland, Ohio.
Operative Neurosurgery (Hagerstown, Md.)
|January 20, 2018
Summary
The Bilateral Extracavitary Approach (BECA) offers enhanced spinal access for decompression. This technique is safe and effective for thoracic and thoracolumbar procedures, with acceptable outcomes and complication rates.
Area of Science:
- Spine surgery
- Neurosurgery
- Orthopedic surgery
Background:
- The Bilateral Extracavitary Approach (BECA) provides greater access to ventral spine aspects.
- It is an option for decompression requiring an extended ventral approach.
Observation:
- A retrospective review of 10 BECA procedures for thoracolumbar decompression was conducted.
- Indications included neoplasm, infection, and kyphotic deformity.
- Average patient age was 58 years, with 80% males.
Findings:
- Estimated blood loss was 1-3 L, with an average postoperative stay of 12 days.
- Two revisions were needed (infection, hardware).
- Eight patients improved ASIA grades, two declined grades.
Implications:
- BECA is an efficient technique for extensive bilateral thoracic or thoracolumbar spine decompression/reconstruction.
- It has acceptable complication rates, comparable to unilateral approaches.
- Consider BECA when extensive ventral access is necessary.
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