Video-assisted thoracoscopic surgery to the upper thoracic spine

Area of Science:

• Minimally Invasive Spinal Surgery
• Thoracic Surgery
• Endoscopic Techniques

Background:

• Standard open thoracotomy for upper thoracic spine (T1-T4) exposure is challenging.
• Video-assisted thoracoscopic surgery (VATS) offers an endoscopic alternative.
• This study evaluates a novel VATS approach for upper thoracic spinal lesions.

Purpose of the Study:

• To assess the safety and efficacy of a new thoracoscopy-assisted spinal technique.
• To evaluate the
• extended manipulating channel method
• for upper thoracic spinal procedures.
• To compare this minimally invasive approach with traditional open surgery.

Main Methods:

• Eight patients with upper thoracic spinal lesions (pyogenic spondylitis, spinal metastases) underwent VATS.
• A novel "extended manipulating channel method" was employed, combining VATS with conventional spinal instruments.
• Patient demographics and diagnoses included ages 44-89, with five presenting with myelopathy.

Main Results:

• No deaths or neurological injuries were reported.
• Mean surgical time was 3.1 hours, with a mean chest tube duration of 3.3 days.
• Complications were minimal (one wound infection, one subcutaneous emphysema), with no conversions to open thoracotomy required.

Conclusions:

• The thoracoscopy-assisted technique with extended manipulating channels is a viable alternative to open surgery.
• This method allows for less procedure-related trauma.
• It provides effective access and manipulation for upper thoracic spinal procedures.