Introduction: Open thoracolumbar corpectomy carries significant morbidity and may require prolonged hospitalization, rehabilitation and pain control for the patients (1). Newer mini-open surgical techniques have the potential to reduce such factors (2).

Methods: Review of our clinical database and patient medical records for sex, direct hospital cost, age at surgery, pre-op BMI, EBL, hospital LOS, duration of surgery, post-operative complications, and patient reported functional outcomes (Oswestry Disability Index-ODI and Visual Analog Scales-VAS). These outcomes are reported at pre-op, 6 weeks, 6 months, and 1 year+ post-operative. We used paired t-test and a two-sample t-test with equal variances to determine means, standard errors, and p-values for statistical significance.

Results: There were 17 patients in the open group and 21 in the mini-open group. There was no significant difference in age, BMI, or length of surgery. Compared to the open group, patients that underwent mini-open surgical technique had less EBL and less hospital LOS (6 vs 9 days). 1 patient in the mini group had revision surgery due to malpositioned instrumentation. Mini-open is a more cost-effective treatment given lower hospital direct costs ($34,373 v $45,376) and better functional outcome at 1+year (Mini-open: ODI pre-op 51.43 to 38.57 at last follow-up; VAS 6.7 to 4.1) compared to open corpectomy (ODI pre-op 44 to 64 at last follow-up; VAS 5.8 to 5.7). Patients that underwent open corpectomy did not have sustainable improvement in their ODI and VAS at last follow-up.

Conclusions: There are very limited publications on direct comparison of minimally invasive thoracotomy approaches to conventional open technique for thoracolumbar copectomies . Our series represent one of the larger studies reporting the benefits of mini-open thoracolumbar corpectomy technique. We conclude that Mini-open corpectomy is a more cost-effective treatment option than OPEN Corpectomy with better and sustained patient–reported functional outcomes.

Patient Care: To our knowledge, this study is the first to compare thoracolumbar corpectomy techniques. This research will be very useful in outlining patient options. It also helps to predict the effectiveness of treatment.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe clinical outcomes after mini-open thoracolumbar corpectomy and how they compare to conventional open corpectomy; 2) Cost effectiveness of mini-open versus open corpectomy

References: 1) Schnake KJ1, Stavridis SI, Kandziora F (2014) Five-year clinical and radiological results of combined anteroposterior stabilization of thoracolumbar fractures. J Neurosurg Spine (Epub ahead of print) 2) Uribe JS, Dakwar E, Cardona RF, Vale FL (2011) Minimmaly invasive lateral retropleural thoracolumbar approach: cadaveric feasibility study and report of 4 clinical cases. Neurosurgery (Suppl Operative) 68:32-9;