Study design Spinal cord decompression in thoracolumbar burst fractures is challenging. Development of minimally invasive approaches and the improvement in new magnification technologies allowed a better and safer surgical treatment for these complex spinal injuries. We reported our experience in the minimally invasive surgical treatment of thoracolumbar burst fractures with spinal cord compression supported by high-definition (HD) three-dimensional (3D) Video-assisted telescope operating monitor (VITOM) or exoscope. Objectives To assess the role and potential advantages of exoscope in the minimally invasive surgery of traumatic thoracolumbar spinal cord compression comparing traditional magnification systems. Setting The study was conducted in a Northern Italy Spinal Trauma Center. Methods We reported 10 consecutive thoracolumbar (T11-L2) burst fractures associated with spinal cord compression treated with minimally invasive corpectomy and exoscope-assisted spinal decompression. Three main indicators were retrospectively analyzed: surgical time, blood loss, and intraoperative complications. The data were compared with those obtained from an equal sample of 10 procedures performed by the same surgeon with the same technique, but traditional microscope assisted. User impressions in terms of ergonomics, magnification, and image quality were rated differently. Results A small reduction of surgical time and blood loss were observed in the exoscope assisted group. There were no intraoperative complications attributed to visualization mode or conversion to the traditional microscope in any procedure. In our experience the exoscope allowed a better magnification and image definition with better ergonomics and user-friendliness. Conclusions In our preliminary experience the exoscope new technology is a safe and effective tool for spinal cord minimally invasive decompression in thoracolumbar burst fractures. The stereoscopic vision provided by 3D images seems to be crucial in hand eye coordination. There are clear advantages in terms of maneuverability, wide field of view, deep focus, and more comfortable posture for the spinal surgeon.

Spinal cord compression in thoracolumbar burst fractures: application of high-definition three-dimensional exoscope in minimally invasive lateral surgery / P.D. Giorgi, M.L. Pallotta, S. Legrenzi, M. Nardi, A. Manzoni, G.R. Schirò. - In: EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY. - ISSN 1432-1068. - (2022), pp. 1-5. [Epub ahead of print] [10.1007/s00590-022-03319-7]

Spinal cord compression in thoracolumbar burst fractures: application of high-definition three-dimensional exoscope in minimally invasive lateral surgery

M.L. Pallotta
Secondo
;
A. Manzoni
Penultimo
;
2022

Abstract

Study design Spinal cord decompression in thoracolumbar burst fractures is challenging. Development of minimally invasive approaches and the improvement in new magnification technologies allowed a better and safer surgical treatment for these complex spinal injuries. We reported our experience in the minimally invasive surgical treatment of thoracolumbar burst fractures with spinal cord compression supported by high-definition (HD) three-dimensional (3D) Video-assisted telescope operating monitor (VITOM) or exoscope. Objectives To assess the role and potential advantages of exoscope in the minimally invasive surgery of traumatic thoracolumbar spinal cord compression comparing traditional magnification systems. Setting The study was conducted in a Northern Italy Spinal Trauma Center. Methods We reported 10 consecutive thoracolumbar (T11-L2) burst fractures associated with spinal cord compression treated with minimally invasive corpectomy and exoscope-assisted spinal decompression. Three main indicators were retrospectively analyzed: surgical time, blood loss, and intraoperative complications. The data were compared with those obtained from an equal sample of 10 procedures performed by the same surgeon with the same technique, but traditional microscope assisted. User impressions in terms of ergonomics, magnification, and image quality were rated differently. Results A small reduction of surgical time and blood loss were observed in the exoscope assisted group. There were no intraoperative complications attributed to visualization mode or conversion to the traditional microscope in any procedure. In our experience the exoscope allowed a better magnification and image definition with better ergonomics and user-friendliness. Conclusions In our preliminary experience the exoscope new technology is a safe and effective tool for spinal cord minimally invasive decompression in thoracolumbar burst fractures. The stereoscopic vision provided by 3D images seems to be crucial in hand eye coordination. There are clear advantages in terms of maneuverability, wide field of view, deep focus, and more comfortable posture for the spinal surgeon.
Exoscope; Minimally invasive; Spine; Spine surgery
Settore MED/27 - Neurochirurgia
2022
26-lug-2022
Article (author)
File in questo prodotto:
File Dimensione Formato  
s00590-022-03319-7.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 857.8 kB
Formato Adobe PDF
857.8 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/953331
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 4
  • ???jsp.display-item.citation.isi??? 2
social impact