The Hybrid Open Muscle-Sparing Approach in Adult Spinal Deformity Patients Undergoing Lower Thoracic Fusion to the Pelvis.

Neurospine
Paul J ParkLawrence G Lenke

Abstract

Proximal junctional kyphosis (PJK) is a difficult complication to manage following adult spinal deformity surgery. Particularly in spinal fusions from the lower thoracic spine down to pelvis, PJK is a major consideration. While the open posterior approach allows for excellent visualization and preparation of bony surfaces for fusion, disruption of posterior soft tissue structures increases risk of PJK postoperatively. Minimally invasive approaches, on the other hand, preserve posterior ligamentous structures and musculature at the proximal fusion levels however prevent the access afforded by an open approach. We describe here the hybrid open muscle-sparing approach-a technique that allows for decortication of bony surfaces as well as clear exposure of anatomic landmarks for freehand pedicle screw placement, while protecting the posterior soft tissue structures to reduce risk of PJK.

References

May 1, 1991·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·T R OxlandJ S Duranceau
Mar 17, 2016·The Journal of the American Academy of Orthopaedic Surgeons·Han Jo Kim, Sravisht Iyer
Jul 27, 2017·Journal of Spine Surgery·Tatsuya YasudaYukihiro Matsuyama

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