Complications of the mini-open anterolateral approach to the thoracolumbar spine

The mini-open anterolateral approach to the thoracolumbar spine is gaining popularity as a minimally-invasive alternative to traditional open thoracolumbar approaches. Published studies reporting and discussing the complications associated with this minimally invasive approach, however, are limited. We performed a retrospective review of patients undergoing the mini-open lateral approach to the thoracolumbar spine for corpectomy/fusion. Intraoperative and postoperative complications are reported and analyzed. Eighty consecutive patients underwent the mini-open lateral approach with corpectomy and fusion for trauma (71%), tumor (26%) and infection (3%). Total complication rate was 12.5% (dural tear 2.5%, intercostal neuralgia 2.5%, deep vein thrombosis 2.5%, pleural effusion 1.3%, wound infection 1.3%, hardware failure 1.3%, hemothorax 1.3%). Two patients needed a re-operation to address the complication (hardware failure, hemothorax). There were no postoperative neurological complications. The mini-open anterolateral approach to the thoracolumbar spine is an appealing alternative to the traditional open approaches. This technique, however, is technically demanding and requires proficiency in the use of minimally invasive spinal surgery instruments and retractors.