Table-mounted ring retractor for consistent visualization in endoscopy-assisted anterior reconstruction of burst fractures of the thoracolumbar junction

Keel, Marius Johann Baptist; Lustenberger, Thomas; Puippe, Gilbert; Benneker, Lorin Michael; Bastian, Johannes Dominik (2013). Table-mounted ring retractor for consistent visualization in endoscopy-assisted anterior reconstruction of burst fractures of the thoracolumbar junction. Acta orthopaedica belgica, 79(1), pp. 90-96. Acta Medica Belgica

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The authors tested an autoclavable external ring retractor, fixed to the operation table, for the endoscopic reconstruction of anterior column injuries of the thoracolumbar junction. It served as a retractor for the diaphragm, and offered a stable support for the scope and other instruments, making an assistant superfluous. Moreover, it allowed bimanual manipulation. Of course, the two-dimensional image, provided by the scope, necessitated proper eye-hand coordination. Twenty-eight consecutive patients underwent either a monosegmental (n = 10) or a bisegmental (n = 18) anterior stabilization in the area Th11L1. Three portals were necessary, but an assistant was not needed. The overall (mean +/- SD) operating time was 196 +/- 56 min, the blood loss was 804 +/- 719 mL. Intraoperatively, one epidural bleeding and a single screw cut-out occurred. All complications were managed endoscopically. Postoperatively, evacuation of a haemothorax (n = 1) was necessary. In all patients, wounds and fractures healed uneventfully. The combination of the endoscopic technique and the retractor system was feasible, successful, safe, and time efficient. Moreover, it allowed for anterior instrumentation of thoracolumbar fractures by a single surgeon. It became the standard approach in the authors' department.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Keel, Marius; Benneker, Lorin Michael and Bastian, Johannes Dominik

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0001-6462

Publisher:

Acta Medica Belgica

Language:

English

Submitter:

Stephanie Schmutz

Date Deposited:

04 Apr 2014 10:48

Last Modified:

10 Sep 2017 01:57

PubMed ID:

23547522

BORIS DOI:

10.7892/boris.42405

URI:

https://boris.unibe.ch/id/eprint/42405

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