A New Thoracic Reconstruction Technique "Transforaminal Thoracic Interbody Fusion" A Preliminary Report of Clinical Outcomes

Study Design. A preliminary clinical study. Objective. The purpose of this study was to introduce a new reconstructive procedure called transforaminal thoracic interbody fusion (TTIF) for thoracic spine lesions and to evaluate its preliminary surgical outcomes. Summary of Background Data. Transforaminal lumbar interbody fusion, which was originally reported as unilateral posterior lumbar interbody fusion, has become a widely used minimally invasive technique. However, such reconstructive procedures have not been reported for the thoracic spine. Methods. Ten patients with thoracic spine lesions associated with neurologic deficits were included in this study (6 males, 4 females; mean age, 53 years). Thoracic spine lesions included thoracic disc herniation, spinal trauma, spinal tumor, and arachnoid cyst. We investigated surgical complications and clinical outcomes such as operative time, blood loss, and sagittal alignment. Bony fusion was assessed using plain radiographs and computed tomography scans. Results. Lesion level was at T11-T12 in 4 cases and T12-L1 in 3, while it was at T7-T9, T9-T11, and T10-T11 in 1 case each. The mean operative time was 192 minutes, and the mean operative bleeding was 588 mL. All patients ambulated within 2 days after surgery. The mean follow-up period was 18.4 months (range, 12-44 months). Preoperative and postoperative local sagittal alignments (kyphotic angles) were 12.9 degrees and 7.0 degrees. Fusion was observed in all cases. There were no serious complications such as neurologic deficit or infection. Conclusion. TTIF provides for safe interbody fusion and 270 degrees of decompression using a single posterior approach. TTIF is a useful method for reconstructing thoracic spine lesions associated with neurologic deficits.