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vol.26 issue3MEASURING THE DISTANCE BETWEEN STERNOCLAVICULAR JOINT AND HILAR STRUCTURES WITH TOMOGRAPHYEVALUATION AND COMPARISON OF OPEN AND CLOSED TIBIA SHAFT FRACTURES IN A QUATERNARY REFERENCE CENTER author indexsubject indexarticles search
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Acta Ortopédica Brasileira

Print version ISSN 1413-7852On-line version ISSN 1809-4406

Abstract

MACHADO, LUCAS CASTRILLON CARMO et al. MINIMALLY INVASIVE EXTREME LATERAL APPROACH IN SPINAL LUMBAR METASTASIS. Acta ortop. bras. [online]. 2018, vol.26, n.3, pp.191-193. ISSN 1809-4406.  https://doi.org/10.1590/1413-785220182603184457.

Introduction

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 decubitus, 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; Neoplasms; Neoplasm metastasis; Spine; Spinal fusion; Operative surgical procedures.

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