You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Anterior Thoracolumbar Corpectomies: Approach Morbidity With and Without an Access Surgeon

Han, Seunggu J MD; Lau, Darryl BA; Lu, Daniel C MD, PhD; Theodore, Pierre MD; Chou, Dean MD

Neurosurgery:
doi: 10.1227/NEU.0b013e31820eb287
Research-Human-Clinical Studies
Abstract

BACKGROUND: Anterior approaches for thoracolumbar corpectomies can have significant morbidity. Spine surgeons have historically performed their own anterior approaches, but recently access surgeons are being used more frequently.

OBJECTIVE: To evaluate the morbidity rates of approaches performed by an access surgeon and by an approach-trained spinal neurosurgeon.

METHODS: From 2004 to 2008, 46 patients undergoing anterior thoracolumbar corpectomies (levels T2-L5) by the senior author (D.C.) were identified and subdivided into 2 groups based on whether an access surgeon was involved. Nine patients were excluded, leaving 37 patients in the final analysis. Blood loss, operative times, length of hospital stay, complications, and neurological outcomes were evaluated.

RESULTS: Eighteen patients had anterior spinal access by an approach-trained spinal neurosurgeon, and 19 patients underwent the approach by an access surgeon. Surgeries performed by the spinal neurosurgeon alone were comparable to those performed by an access surgeon with respect to operative time, days spent in the hospital, blood loss, complication rates, and improvement in neurological function.

CONCLUSION: There appears to be no increased morbidity of anterior approaches performed by an approach-trained spinal neurosurgeon compared with approaches performed by an access surgeon in terms of operative time, complication rate, and improvement in neurological function.

Author Information

*Department of Neurological Surgery, University of California San Francisco, San Francisco, California; ‡Department of Neurological Surgery, University of California Los Angeles, Los Angeles, California; §Division of General Thoracic Surgery, Department of Surgery, University of California San Francisco, San Francisco, California

Received, February 2, 2010.

Accepted, September 10, 2010.

Correspondence: Dean Chou, MD, Department of Neurological Surgery, University of California at San Francisco, 505 Parnassus Ave, Box 0112, San Francisco, CA 94143. E-mail: choud@neurosurg.ucsf.edu

Copyright © by the Congress of Neurological Surgeons