Author/Authors :
castriLLon carmo machado, Lucas Institute of Orthopedics and Traumatology - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - São Paulo, Brazil , Kenji narazaKi, dougLas Institute of Orthopedics and Traumatology - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - São Paulo, Brazil , gemio jacobsen teixeira, WiLLian Institute of Orthopedics and Traumatology - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - São Paulo, Brazil , Fogaça cristante, aLexandre Institute of Orthopedics and Traumatology - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - São Paulo, Brazil , jacobsen teixeira, manoeL Institute of Orthopedics and Traumatology - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - São Paulo, Brazil , eLoy Pessoa de barros FiLho, tarcísio Institute of Orthopedics and Traumatology - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP) - São Paulo, Brazil
Abstract :
ntroduction: The extreme lateral approach has been widely
used for the treatment of degenerative diseases. The objective
of this study is to present a minimally invasive extreme lateral
approach for the treatment of metastatic lesions in the lumbar
spine without the use of the evoked potential exam (MEP).
Methods: Two patients with spinal metastases and indication
for surgery via the anterior approach were treated in a cancer
referral center in Brazil. They were placed in right lateral decu-
bitus, and an oblique incision was made, exposing the psoas
muscle. The anterior approach permitted the release of the
psoas muscle from vertebral body and disc, without the need
for MEP. Conclusions: When cancer cure is no longer possible,
a minimally invasive extreme lateral approach to treat tumor
metastases in the lumbar spine is a viable option, with short
hospitalization time and low morbidity. The dislocation of the
psoas muscle avoids the use of the transpsoas approach,
which requires MEP equipment and a trained physician. Clinical
studies are needed to extend these benefits to oncological
patients who have treatment options for their primary disease.
Level of Evidence IV; Case series
Keywords :
Minimally invasive surgical procedures , Neo- plasms , Neoplasm metastasis , Spine , Spinal fusion , Operative surgical procedures
