Video-assisted paraspinal approach for the stabilization of the complex spine

Access to complex conditions of the thoracic spine and of the posterior mediastinum offers significant challenges, especially if the surgeon wishes to comply with the principles of minimal invasiveness. We report a successful vertical, paraspinal incision along with the subperiosteal removal of the overlying 2-cm rib segments combined with video assistance through single-access video-assisted thoracic surgery to perform a total T6 and partial T7 corpectomy for a metastatic multiple myeloma in a 50-year old man. This approach appears to provide excellent exposure and minimal morbidity when a reliable approach to the complex spine is needed.