Microcirculation in open vs. minimally invasive dorsal stabilization of thoracolumbar fractures
Standard open and percutaneous minimally invasive surgical procedures co-exist in the treatment of fractures of the thoracolumbar spine. Shorter skin incisions just above the pedicles are used in minimally invasive procedures. Full-length skin incisions and invasive preparations are applied in the s...
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| creator | Ganse, Bergita Pishnamaz, Miguel Kobbe, Philipp Herren, Christian Gradl-Dietsch, Gertraud Böhle, Franziska Johannes, Bernd Kim, Bong-Sung Horst, Klemens Knobe, Matthias |
| description | Standard open and percutaneous minimally invasive surgical procedures co-exist in the treatment of fractures of the thoracolumbar spine. Shorter skin incisions just above the pedicles are used in minimally invasive procedures. Full-length skin incisions and invasive preparations are applied in the standard open approach. While both methods show equivalent rates of intraoperative surgical complications and comparable clinical and radiological outcomes, blood loss and operation time have shown to be decreased in minimally invasive treatment. However, no study so far has investigated differences in microcirculation. This study hypothesized less impairment of microcirculation in the minimally invasive approach compared to the open approach and an improvement of microcirculation over time. A prospective cohort study was conducted using non-invasive laser-Doppler spectrophotometry (an O2C "oxygen to see" device) for measurement of cutaneous and subcutaneous blood oxygenation (SO2), haemoglobin concentration (Hb), and blood flow at depths of 2, 8, and 15 mm at six locations on the skin. Measurements were performed before surgery, 8 and 24 h after surgery, and 2, 4, 7, 12 and 20 days after surgery, however the number of patients measured decreased towards the later time points. Forty patients were included in the study, 20 with each approach (18 females and 22 males). Pair-wise comparison of the types of surgical procedure for each measurement point revealed a significantly higher flow value in the minimally invasive group at one of the measurement points located between the incisions (P = .041). The point-wise analyses of SO2 and Hb did not show significant differences between the approaches. In conclusion, significantly albeit moderately higher flow values could be found in minimally invasive procedures compared to open operations of thoracolumbar fractures in the area of skin that is spared by the incisions. |
| doi_str_mv | 10.1371/journal.pone.0188115 |
| format | Article |
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Shorter skin incisions just above the pedicles are used in minimally invasive procedures. Full-length skin incisions and invasive preparations are applied in the standard open approach. While both methods show equivalent rates of intraoperative surgical complications and comparable clinical and radiological outcomes, blood loss and operation time have shown to be decreased in minimally invasive treatment. However, no study so far has investigated differences in microcirculation. This study hypothesized less impairment of microcirculation in the minimally invasive approach compared to the open approach and an improvement of microcirculation over time. A prospective cohort study was conducted using non-invasive laser-Doppler spectrophotometry (an O2C "oxygen to see" device) for measurement of cutaneous and subcutaneous blood oxygenation (SO2), haemoglobin concentration (Hb), and blood flow at depths of 2, 8, and 15 mm at six locations on the skin. Measurements were performed before surgery, 8 and 24 h after surgery, and 2, 4, 7, 12 and 20 days after surgery, however the number of patients measured decreased towards the later time points. Forty patients were included in the study, 20 with each approach (18 females and 22 males). Pair-wise comparison of the types of surgical procedure for each measurement point revealed a significantly higher flow value in the minimally invasive group at one of the measurement points located between the incisions (P = .041). The point-wise analyses of SO2 and Hb did not show significant differences between the approaches. In conclusion, significantly albeit moderately higher flow values could be found in minimally invasive procedures compared to open operations of thoracolumbar fractures in the area of skin that is spared by the incisions.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0188115</identifier><identifier>PMID: 29141048</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Anesthesiology ; Biology and Life Sciences ; Blood ; Blood flow ; Blood levels ; Bone surgery ; Complications ; Diabetes ; Females ; Foot diseases ; Fractures ; Hemoglobin ; Hospitals ; Infections ; Injuries ; Males ; Medicine and Health Sciences ; Microcirculation ; Oxygen ; Oxygenation ; Patients ; Physical Sciences ; Physiological aspects ; Skin ; Skin preparations ; Spectrophotometry ; Spine ; Sulfur dioxide ; Surgery ; Trauma</subject><ispartof>PloS one, 2017-11, Vol.12 (11), p.e0188115-e0188115</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Ganse et al. 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Shorter skin incisions just above the pedicles are used in minimally invasive procedures. Full-length skin incisions and invasive preparations are applied in the standard open approach. While both methods show equivalent rates of intraoperative surgical complications and comparable clinical and radiological outcomes, blood loss and operation time have shown to be decreased in minimally invasive treatment. However, no study so far has investigated differences in microcirculation. This study hypothesized less impairment of microcirculation in the minimally invasive approach compared to the open approach and an improvement of microcirculation over time. A prospective cohort study was conducted using non-invasive laser-Doppler spectrophotometry (an O2C "oxygen to see" device) for measurement of cutaneous and subcutaneous blood oxygenation (SO2), haemoglobin concentration (Hb), and blood flow at depths of 2, 8, and 15 mm at six locations on the skin. 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In conclusion, significantly albeit moderately higher flow values could be found in minimally invasive procedures compared to open operations of thoracolumbar fractures in the area of skin that is spared by the incisions.</description><subject>Anesthesiology</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Blood flow</subject><subject>Blood levels</subject><subject>Bone surgery</subject><subject>Complications</subject><subject>Diabetes</subject><subject>Females</subject><subject>Foot diseases</subject><subject>Fractures</subject><subject>Hemoglobin</subject><subject>Hospitals</subject><subject>Infections</subject><subject>Injuries</subject><subject>Males</subject><subject>Medicine and Health Sciences</subject><subject>Microcirculation</subject><subject>Oxygen</subject><subject>Oxygenation</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Physiological aspects</subject><subject>Skin</subject><subject>Skin 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One</addtitle><date>2017-11-15</date><risdate>2017</risdate><volume>12</volume><issue>11</issue><spage>e0188115</spage><epage>e0188115</epage><pages>e0188115-e0188115</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Standard open and percutaneous minimally invasive surgical procedures co-exist in the treatment of fractures of the thoracolumbar spine. Shorter skin incisions just above the pedicles are used in minimally invasive procedures. Full-length skin incisions and invasive preparations are applied in the standard open approach. While both methods show equivalent rates of intraoperative surgical complications and comparable clinical and radiological outcomes, blood loss and operation time have shown to be decreased in minimally invasive treatment. However, no study so far has investigated differences in microcirculation. This study hypothesized less impairment of microcirculation in the minimally invasive approach compared to the open approach and an improvement of microcirculation over time. A prospective cohort study was conducted using non-invasive laser-Doppler spectrophotometry (an O2C "oxygen to see" device) for measurement of cutaneous and subcutaneous blood oxygenation (SO2), haemoglobin concentration (Hb), and blood flow at depths of 2, 8, and 15 mm at six locations on the skin. Measurements were performed before surgery, 8 and 24 h after surgery, and 2, 4, 7, 12 and 20 days after surgery, however the number of patients measured decreased towards the later time points. Forty patients were included in the study, 20 with each approach (18 females and 22 males). Pair-wise comparison of the types of surgical procedure for each measurement point revealed a significantly higher flow value in the minimally invasive group at one of the measurement points located between the incisions (P = .041). The point-wise analyses of SO2 and Hb did not show significant differences between the approaches. In conclusion, significantly albeit moderately higher flow values could be found in minimally invasive procedures compared to open operations of thoracolumbar fractures in the area of skin that is spared by the incisions.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29141048</pmid><doi>10.1371/journal.pone.0188115</doi><tpages>e0188115</tpages><orcidid>https://orcid.org/0000-0002-9512-2910</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesiology Biology and Life Sciences Blood Blood flow Blood levels Bone surgery Complications Diabetes Females Foot diseases Fractures Hemoglobin Hospitals Infections Injuries Males Medicine and Health Sciences Microcirculation Oxygen Oxygenation Patients Physical Sciences Physiological aspects Skin Skin preparations Spectrophotometry Spine Sulfur dioxide Surgery Trauma |
| title | Microcirculation in open vs. minimally invasive dorsal stabilization of thoracolumbar fractures |
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