Abstract
Endoscopic techniques lead to higher numbers of anterior procedures to the vertebral column. Navigation systems can assist to more precision using less x-rays. We registered prospectively more than 100 cases of anterior stabilization of the thoracic and lumbar spine using minimally invasive technique, endoscopic assistance and CT-based navigation. Patients were observed continuously over a time period of at least 12 month according to a standardized protocol.
135 patients were recorded prospectively between January 2002 September 2004. All patients recieved anterior procedures using endoscopical assistance. Operations were performed in prone position using Synframe® and navigation system by BrainLab®. The follow up of at least one year consisted in clinical investigations and radiographs 6 weeks, 3, 6, 9 and 12 months post OP.
87 male and 48 female patients were recorded with a mean age of 41 (16–77) years. 47 isolated anterior and 88 combined antero-posterior spondylodeses were performed with the described technique. In 101 cases thoracoscopy was used. For the instrumentation of L3, mini-lumbotomy was necessary which was also combined with Synframe® and endoscopical assistance. Isolated anterior procedures were completed under navigation control in 29 and combined antero-posterior procedures in 71 cases. Image intensifier times were reduced up to 85%, op-times were shortened using navigation for a mean of 22 minutes.
Navigation procedures showed initial learning curve. However, after this initial time it was a useful techique to enlarge precision and reduce op-times as well as x-ray exposition. The further standardization of the procedure lead to the development of advantageous instruments that further on will lead to even higher acceptance of this new technique.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
