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Abstract
Objectives
To report a case of video-assisted thoracoscopic (VAT) minimally invasive anterior interbody fusion of the T11-T12 level using direct lateral interbody fusion (DLIF) devices.
Summary of Literature Review
Interbody fusion of the thoracolumbar junction (especially T11-T12) is technically challenging from anterior, lateral, or posterior approaches. A VAT anterior interbody fusion approach using DLIF devices is a safe, minimally invasive alternative approach to the thoracolumbar spine.
Materials and Methods
A 37-year-old male pedestrian was struck by a car sustaining fracture-dislocation at the T11-T12 level. The accident resulted in complete paraplegia of both lower extremities and multiple lower extremity fractures. A classical instrumented posterolateral fusion from T8 to L3 and staged VAT anterior interbody fusion at the T11-T12 level were performed.
REFERENCES
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2. Wang X-B, Yang M, Li J, et al. Thoracolumbar fracture dislocations treated by posterior reduction, interbody fusion and segmental instrumentation. Indian J Orthop. 2014; 48:568–73.
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Fig. 1.
The plain radiographs of 37-year-old male pedestrian, who was struck by a car, show fracture-dislocation injury at the T11-T12 level (A, B). The accident resulted in complete paraplegia of both lower extremities.
Fig. 2.
Sagittal (A), coronal (B), and axial (C) computed tomography scans and magnetic resonance imaging (D) show fracture-dislocation injury at the T11-T12 level. A transection cord injury at the T11 body level, lateral displacement with intervertebral subluxation, and fracture at both superior articular processes of the T12 vertebra occurred.
Fig. 3.
Lateral radiographs of the surgical site preoperatively (A) and after posterior operation (B) are shown. After the posterior operation, the T11-T12 interbody space was widened from 5 mm to 12 mm and facet joint subluxation still existed.
Fig. 4.
A thoracoscopic image shows the T11-T12 level (A). The dia-phragm (asterisk) was detached from the chest wall to expose the T11-T12 interbody disc space. A guide pin was inserted at the T11-T12 interbody disc space. An intraoperative image is shown (B). Serial dila-tors were inserted directly lateral to the T11-T12 interbody disc space. A viewing camera and instruments for thoracoscopy were inserted via trocars.
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