543 - Midline “Mini Open” Approach to Multilevel Posterior Cervical Decompre...

#543 Midline “Mini Open” Approach to Multilevel Posterior Cervical Decompression and Fusion

MIS Techniques and Outcomes

Poster Presented by: O.L. Alves

Author(s):

O.L. Alves (1)
M.J. Coelho (2)
P. Santos (3)
A.A. Baptista (3)

(1) Centro Hospitalar de Gaia/Espinho and Hospitais Privados de Portugal - Boavista, Vila Nova de Gia, Portugal
(2) Hospitais Privados de Portugal - Boavista, Neurosurgery, Porto, Portugal
(3) Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal

Abstract

Introduction: One of the disadvantages of posterior cervical approach is the extensive muscle splitting to access and decompress neural elements. This form of decompression causes significant operative morbidities, including pain, bleeding, and infection, that increase costs and decrease patient satisfaction. In an attempt to overcome these problems, we report on the clinical results of a posterior mini-open approach to cervical spine using special type of retractors.

Materials and Methods: 18 patients were approached to the posterior cervical spine through a less than 5cm skin incision, using special tubular retractors. Patients were evaluated for intra-operative blood loss, pain scales as neck disability index (NDI), neck VAS, time of hospitalisation and satisfaction index.

Results: 7 female and 11 male patients, with mean age of 64 years old were operated for laminectomy and lateral mass fusion with a mean follow-up of 9 months. Mean skin incision was 4,2 cm. A mean of 3,2 cervical levels were operated per patient. The estimated mean blood loss was 150mL. A mean of 2,5 days of hospitalisation was achieved. Mean neck VAS decrease from 8,3 to 1,4 and mean NDI from 34 to 6. 90% of patients were satisfied or very satisfied, with no record of the novo neurological deficits or infection. 95% of patients would be operated again.

Discussion and Conclusions: Midline mini-open approach to posterior cervical spine is a feasible technique with small amounts of blood loss, short time of hospitalisation, effective improvement of neck pain indexes and good satisfaction index without compromising in terms of decompression and instrumentation as offered by extended open procedures.