[A case report of transverso-arthropediculectomy for thoracic spondylosis]

We report a case of a 23-year-old male with thoracic spondylosis at the T2/3 level. He complained of lumbago and gait disturbance (spastic paraparesis and sensory disturbance below the T4 level). Preoperative CT myelography showed a posterolateral spur at the left paramedian site which was compressing the spinal cord. We performed drilling of the spur using the posterolateral approach, and decompressed the spinal cord. After surgery, the motor weakness and sensory disturbance gradually improved and spasticity was reduced. Postoperative CT showed complete decompression of the spinal cord and no spur. In cases of upper thoracic lesions, there are various kinds of posterolateral approaches for decompression of the ventral side of the spinal cord. We adopted transverso-arthropediculectomy for this case, because this approach is minimally invasive of the costotransverse joint and the spinal cord. We discuss the other posterolateral approaches, in terms of merits and demerits for the vertebra and spinal cord.