Anterior decompression of the thoracic and thoraco-lumbar spine

The authors report their experience with six cases of acute spinal cord compression due to tumor, trauma, and infection in which the thoraco-lumbar spine and cord were most satisfactorily decompressed using an anterior transthoracic approach. Consideration is given to the appropriate pre-operative diagnostic procedures utilized to define those cases that are most amenable to an anterior approach. In addition, a consideration of paravertebral anatomy in the thoraco-lumbar area provides a basis for variance in approaching the ventral aspect of the thoraco-lumbar spine in order to minimize potential vascular complications.