| 摘要 |
Purpose: Most neurosurgeons in Taiwan are not trained formally to perform anterior approaches for thoracolumbar corpectomies in the treatment of thoracolumbar lesions during their residencies. Often, such procedures are conducted with the assistance of “access surgeons”.
Materials and methods: Prior to performing anterior thoracolumbar corpectomies in clinical cases, one senior neurosurgeon, who was not trained in the anterior approaches, acquired the relevant skills from cooperating access surgeons, by attending a workshop, and by practicing on cadavers. Between December 2006 and March 2011, 18 consecutive patients underwent surgeries involving the anterior approach to thoracolumbar lesions. Patients operated on by the self-trained neurosurgeon were included in Group 1, and those operated on by neurosurgeons
assisted by access surgeons were included in Group 2. Operative time, blood loss, complications, and neurologic outcomes were compared between the two groups.
Results: Group 1 consisted of 10 patients (4 men), with a mean age of 62.5 years, and Group 2 of eight patients (5 men), with a mean age of 58.3 years. The median follow-up periods for both groups were 15.5 and 17 months, respectively. Operative time, blood loss, rate of complications, and neurologic outcomes were comparable between the two groups.
Conclusion: Through observation, by attending workshops, and by practicing the anterior approach on cadavers, the self-trained neurosurgeon became competent in the anterior thoracolumbar corpectomy and achieved comparable results to surgeons who were assisted by access surgeons in terms of operative time, blood loss, complications, and neurologic outcomes. |
