Extrapleural Approach for Spinal Injury or Degenerative Diseases of the Thoracic Spine

Abstract

  The transthoracic or extrapleural approach to the thoracic spine, which provides a wide operative field and direct vision to the vertebral column, has been used to resect abnormalities of the thoracic vertebrae, to decompress the thoracic spinal cord, and to reconstruct the thoracic vertebral bodies. The procedures, however, remains unfamiliar to neurosurgeons as well as spinal surgeons because it is thought to be invasive and to be associated with several major complications. We have used this approach for about a hundred patients with thoracic spinal injuries, neoplasms, degenerative diseases and vertebral body infections and have achieved excellent operative result with only rare and minor complications. This paper describes our operative technique for using the extrapleural approach and the significance of the procedure for treating thoracic spine injuries and degenerative diseases.