Lateral Access Surgery for the Thoracolumbar Spine
نویسندگان
چکیده
e advent of minimally invasive surgery has provided surgeons and patients the same good treatment alternatives. Within the �eld of spine surgery, techniques for lumbar interbody arthrodesis have shown enormous evolution. e retroperitoneal transpsoas lateral approach for the lumbar spine has revolutionized how interbody fusions can be performed more safely and with signi�cantly less morbidity. In recent years, the role of minimally invasive transpsoas interbody fusion is strongly evolving. Lateral retroperitoneal approaches under direct visualization using expandable retractors have gained space and have been utilized for different purposes rather than interbody fusion.eobjective of this special issue was to, for the �rst time in the literature, gather together articles on Lateral Access Surgery (LAS) and assemble unique peer-reviewed literature with basic and advanced reports focused in this emerging area. enumber of scienti�c articles aboutminimally invasive spine surgery (MISS) and specially about LAS is growing. e nature of the research tends to go to the same direction and evolve from single-center case reports to a higher level of evidence trials, once a recognized weakness in the MIS literature is the absence of randomized controlled trials. But by the other hand, randomizing patients were found to be challenging faced to patients’ expectative and ethical principles. Given the challenges of conducting a randomized controlled trial and although more substantial research remains to be performed, nonrandomized concurrently controlled trials or prospective registries will provide valuable evidence-basedmedicine data.e level of evidence provided from the clinical and basic studies included in this special issue is not at the highest level of clinical trials, but though they represent different aims and indications for the lateral access, it can identify two patterns across them—safety and efficacy. Among the table of content of this issue, V. S. Patel et al. go through overall indications and outcomes, while M. Malham et al. from Australia show results from their initial experience with the technique. e use of an allogra as bone gra option is well reported by A. G. Tohmeh et al. Basic science developments are illustrated with studies on biomechanics of interbody constructions and on the validation of an animal model. First developed for anterior based discectomy and interbody graing in simple degenerative diseases, LAS has recently gained space for more complex indications. Over the years, it has been possible to address varied and complex scenarios. In this mindset, this special issue brings important reports that discuss advanced surgical applications of LAS—release of the ALL and sagittal reconstruction, degenerative scoliosis, application for revision surgery and thoracolumbar infection, and for L4-5 grade 2 spondylolisthesis. We look forward to witness the evolution of spine surgery with the evidence based medicine to achieve the highest efficacy and safe to the patient who suffers from any spinerelated condition.
منابع مشابه
Anterior Cervical Incision and Thoracotomy for Cervico-thoracic, Thoracic, and Thoracolumbar Spine Surgery: A Clinical Series
Introduction:Surgical treatment of diseases in cervicothoracic, thoracic and thoracolumbar regions can be a challenging issue. Cooperation of the thoracic surgeons and spine surgeons can improve the outcomes and decrease the complications of patients who underwent these approaches.Materials & Methods: The participants of this study consisted of seventeenpatients suffering from different types o...
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ورودعنوان ژورنال:
دوره 2013 شماره
صفحات -
تاریخ انتشار 2013