{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:49:20Z","timestamp":1792644560315,"version":"4.5.0"},"reference-count":60,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2014,3]]},"abstract":"\n Object<\/jats:title>\n Video-assisted thoracoscopic surgery (VATS) has evolved for treatment of a variety of spinal disorders. Early incorporation with image-guided surgery (IGS) was challenged due to reproducibility and adaptability, limiting the procedure's acceptance. In the present study, the authors report their experience with second-generation IGS and VATS technologies for anterior thoracic minimally invasive spinal (MIS) procedures.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The surgical procedure is described in detail including operating room set-up, patient positioning (a lateral decubitus position), placement of the spinal reference frame and portal, radiographic localization, registration, surgical instruments, and the image-guided thoracoscopic discectomy.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Combined IGS and VATS procedures were successfully performed and assisted in anatomical localization in 14 patients. The mean patient age was 59 years (range 32\u201373 years). Disc herniation pathology represented the most common indication for surgery (n = 8 patients); intrathoracic spinal tumors were present in 4 patients and the remaining patients had infection and ossification of the posterior longitudinal ligament. All patients required chest tube drainage postoperatively, and all but 1 patient had drainage discontinued the following day. The only complication was a seroma that was presumed to be due to steroid therapy for postoperative weakness. At the final follow-up, 11 of the patients were improved neurologically, 2 patients had baseline neurological status, and the 1 patient with postoperative weakness was able to ambulate, albeit with an assistive device.<\/jats:p>\n The evolution of thoracoscopic surgical procedures occurring over 20 years is presented, including their limitations. The combination of VATS and IGS technologies is discussed including their safety and the importance of 3D imaging. In cases of large open thoracotomy procedures, surgeries require difficult, extensive, and invasive access through the chest cavity; using a MIS procedure can potentially eliminate many of the complications and morbidities associated with large open procedures. The authors report their experience with thoracic spinal surgeries that involved MIS procedures and the new technologies.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The most significant advance in IGS procedures has resulted from intraoperative CT scanning and automatic registration with the IGS workstation. Image guidance can be used in conjunction with VATS techniques for thoracic discectomy, spinal tumors, infection, and ossification of the posterior longitudinal ligament. The authors' initial experience has revealed this technique to be useful and potentially applicable to other MIS procedures.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.1.focus13532","type":"journal-article","created":{"date-parts":[[2014,3,1]],"date-time":"2014-03-01T03:37:03Z","timestamp":1393645023000},"page":"E8","source":"Crossref","is-referenced-by-count":20,"title":["Image-guided navigation and video-assisted thoracoscopic spine surgery: the second generation"],"prefix":"10.3171","volume":"36","author":[{"given":"J. Patrick","family":"Johnson","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, UC Davis Medical Center, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doniel","family":"Drazin","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley A.","family":"King","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence T.","family":"Kim","sequence":"additional","affiliation":[{"name":"Orthopaedics, Cedars-Sinai Medical Center, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0360008","series-title":"Spine (Phila Pa 1976)","first-page":"871","article-title":"Video-assisted thoracoscopic surgery for thoracic disc disease: classification and outcome study of 100 consecutive cases with a 2-year minimum follow-up period","volume":"27","author":"Anand","year":"2002"},{"key":"b2-0360008","series-title":"Spine (Phila Pa 1976)","first-page":"1705","article-title":"Image-guided endoscopic spine surgery: Part I. A feasibility study","volume":"26","author":"Assaker","year":"2001"},{"key":"b3-0360008","series-title":"Spine (Phila Pa 1976)","first-page":"1711","article-title":"Image-guided endoscopic spine surgery: Part II: clinical applications","volume":"26","author":"Assaker","year":"2001"},{"issue":"2 Suppl","key":"b4-0360008","series-title":"J Neurosurg","first-page":"175","article-title":"Image-guided surgery: applications to the cervical and thoracic spine and a review of the first 120 procedures","volume":"92","author":"Bolger","year":"2000"},{"key":"b5-0360008","series-title":"Spine (Phila Pa 1976)","first-page":"1592","article-title":"The surgical and medical perioperative complications of anterior spinal fusion surgery in the thoracic and lumbar spine in adults. A review of 1223 procedures","volume":"20","author":"Faciszewski","year":"1995"},{"key":"b6-0360008","series-title":"Neurosurg Clin N Am","first-page":"171","article-title":"Image-guided spine surgery","volume":"7","author":"Foley","year":"1996"},{"key":"b7-0360008","series-title":"Neurosurgery","first-page":"461","article-title":"Image-guided thoracoscopic resection of thoracic dumbbell nerve sheath tumors","volume":"70","author":"Ghostine","year":"2012"},{"key":"b8-0360008","series-title":"Spine (Phila Pa 1976)","first-page":"2026","article-title":"Computer-aided pedicle screw placement using frameless stereotaxis","volume":"21","author":"Glossop","year":"1996"},{"key":"b9-0360008","series-title":"Comput Aided Surg","first-page":"18","article-title":"Incorporation of intraoperative computerized tomography in a newly developed spinal navigation technique","volume":"5","author":"Haberland","year":"2000"},{"key":"b10-0360008","series-title":"J Neurosurg Spine","first-page":"323","article-title":"Evaluation of registration techniques for spinal image guidance","volume":"4","author":"Holly","year":"2006"},{"issue":"2 Suppl","key":"b11-0360008","series-title":"J Neurosurg","first-page":"196","article-title":"Frameless stereotaxy for anterior spinal procedures","volume":"95","author":"Holly","year":"2001"},{"key":"b12-0360008","series-title":"Surg Endosc","first-page":"346","article-title":"Complications in thoracoscopic spinal surgery: a study of 90 consecutive patients","volume":"13","author":"Huang","year":"1999"},{"issue":"4","key":"b13-0360008","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Endoscopic thoracic discectomy","volume":"9","author":"Johnson","year":"2000"},{"key":"b14-0360008","series-title":"Spine (Phila Pa 1976)","first-page":"E572","article-title":"Image-guided thoracoscopic spinal surgery: a merging of 2 technologies","volume":"30","author":"Johnson","year":"2005"},{"key":"b15-0360008","series-title":"J Neurosurg","first-page":"641","article-title":"Application of frameless stereotaxy to pedicle screw fixation of the spine","volume":"83","author":"Kalfas","year":"1995"},{"issue":"2","key":"b16-0360008","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Image-guided thoracic pedicle screw placement: a technical study in cadavers and preliminary clinical experience","volume":"10","author":"Kim","year":"2001"},{"key":"b17-0360008","series-title":"Spine (Phila Pa 1976)","first-page":"360","article-title":"Computer-assisted thoracic pedicle screw placement: an in vitro feasibility study","volume":"26","author":"Kim","year":"2001"},{"key":"b18-0360008","series-title":"Neurosurgery","first-page":"173","article-title":"Universal calibration of surgical instruments for spinal stereotaxy","volume":"44","author":"Kim","year":"1999"},{"key":"b19-0360008","series-title":"Ann Thorac Surg","first-page":"1285","article-title":"Postoperative pain-related morbidity: video-assisted thoracic surgery versus thoracotomy","volume":"56","author":"Landreneau","year":"1993"},{"key":"b20-0360008","series-title":"Ann Thorac Surg","first-page":"736","article-title":"Application of thoracoscopy for diseases of the spine","volume":"56","author":"Mack","year":"1993"},{"key":"b21-0360008","series-title":"Spine (Phila Pa 1976)","first-page":"1624","article-title":"The incidence of complications in endoscopic anterior thoracolumbar spinal reconstructive surgery. 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