F. Rubino et al., Minimally invasive spine surgery: An animal model for endoscopic approach to the anterior cervical and upper thoracic spine, J LAP ADV A, 10(6), 2000, pp. 309-313
Citations number
26
Categorie Soggetti
Surgery
Journal title
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES-PART A
Background: Minimally invasive video-assisted techniques are currently used
for thoracic and lumbar spine surgery with the aim of reducing the morbidi
ty. Recently, an endoscopic approach has been used for endocrine neck surge
ry, with reduced pain and improved cosmetic results.
Purpose: To develop an animal model for an endoscopic neck approach to the
anterior cervical and upper thoracic spine.
Methods: Five pigs were used. A combination of one 5- and two 3-mm laparosc
opic instruments was used to dissect the spine, and dedicated instrumentati
on was then used to perform discectomies. Carbon dioxide was insufflated at
10 mm Hg. Dissection was carried out upward and downward on the anterior a
spect of the spine; discectomy was performed at various levels and evaluate
d at autopsy.
Results: All pigs tolerated the procedure well. Visibility of the cervical
spine was excellent, and exposure from C1 to T3 was obtained. For discectom
y, an additional 10-mm trocar was inserted, and discectomy of C3-C4 and C4-
C5 was performed. Proper location and adequacy were confirmed at autopsy.
Conclusion: The endoscopic neck approach allows exposure of the entire cerv
ical spine and the upper thoracic spine in the porcine model. This approach
has the potential to reduce the morbidity associated with the open cervica
l approach and provides a wider view and exposure than conventional open su
rgery. The availability of the porcine model allows the acquisition of the
necessary technical skills before introducing this advanced procedure in hu
mans.