Should Mini-Thoracotomy Be the Preferred Anterior Approach to the Thoracic Spine?

Area of Science:

• Neurosurgery
• Thoracic Surgery
• Minimally Invasive Surgery

Background:

• Anterior approaches to the thoracic spine are crucial for treating various spinal pathologies.
• Conventional open thoracotomy (COT) is a well-established but invasive technique.
• Mini-thoracotomy (MT) offers a less invasive alternative, but its comparative outcomes require further investigation.

Purpose of the Study:

• To compare the short- and mid-term surgical outcomes between mini-thoracotomy (MT) and conventional open thoracotomy (COT) for anterior thoracic spine surgery.
• To evaluate complications, post-operative pain, and other recovery metrics in both surgical approaches.

Main Methods:

• A retrospective review of adult patients undergoing anterior thoracic spine surgery between 2016 and 2021.
• Comparison of outcomes between the MT (n=14) and COT (n=17) cohorts.
• Statistical analysis using IBM SPSS Statistics, version 28, with a p-value threshold of <0.05.

Main Results:

• No significant demographic differences were observed between the MT and COT groups.
• MT showed a trend towards fewer complications, though not statistically significant.
• The MT group experienced a statistically significant 80% shorter post-operative intensive care unit (ICU) stay (p=0.034).
• Post-operative pain levels were lower at 48 hours for MT but higher on discharge.

Conclusions:

• Mini-thoracotomy (MT) is non-inferior to conventional open thoracotomy (COT) for anterior thoracic spine procedures.
• MT is associated with a significantly shorter ICU stay and potentially other favorable outcomes.
• Larger studies are needed to confirm the statistical significance and clinical relevance of MT's benefits.