Implementation of Robotic Exoscope in Minimally Invasive Corpectomy at Thoracolumbar Junction for the Treatment of Traumatic Spinal Cord Compression

World Neurosurg. 2024 Apr:184:23-28. doi: 10.1016/j.wneu.2023.12.163. Epub 2024 Jan 5.

Abstract

The development and diffusion of minimally invasive (MI) approaches have coincided with improvements in magnification systems. The exoscope will probably open a new era in new technologies in spinal surgery. This study reports a retrospective series of 19 thoracolumbar (T11-L2) burst fractures with anterior column failure and cord compression, treated with MI corpectomy and spinal decompression assisted by a three-dimensional high-definition exoscope (Video 1). Exclusion criteria were pathologic or osteoporotic fractures, multilevel fractures, and previous surgery at the site of the fracture. Three key indicators were recorded: surgical time, blood loss, and intraoperative complications. A questionnaire was administered to assess the users' exoscope experience with ergonomics, preparation, magnification, image definition, illumination, and user-friendliness, compared with the operative microscope. To the best of our knowledge, this is the first study reporting on exoscope-assisted MI corpectomy. This procedure permitted low blood loss and less surgical time without intraoperative complications. The exoscope offers clear advantages in terms of ergonomics, definition, and user-friendliness. Moreover, it is a suitable instrument for training and education, providing an opportunity for better interaction with other members of the surgical staff.

Keywords: Corpectomy; Exoscope; Minimally invasive; Spine; Spine surgery.

Publication types

  • Video-Audio Media

MeSH terms

  • Humans
  • Intraoperative Complications / surgery
  • Lumbar Vertebrae / injuries
  • Lumbar Vertebrae / surgery
  • Minimally Invasive Surgical Procedures / methods
  • Neurosurgical Procedures / methods
  • Retrospective Studies
  • Robotic Surgical Procedures*
  • Spinal Cord Compression* / etiology
  • Spinal Cord Compression* / surgery
  • Spinal Fractures* / surgery
  • Thoracic Vertebrae / injuries
  • Thoracic Vertebrae / surgery