Mini-open lateral retro-pleural thoracic corpectomy for osteomyelitis.

Area of Science:

• Spinal surgery
• Minimally invasive techniques
• Thoracic spine pathology

Background:

• Thoracic vertebral corpectomy for deformity and neural compression presents surgical challenges.
• Existing approaches (trans-pedicular, costotransversectomy, trans-thoracic) have distinct limitations and complication profiles.
• A mini-open retro-pleural approach is explored as a less invasive alternative.

Observation:

• A case of a 56-year-old male with T-9 & T-10 osteomyelitis/discitis, progressive deformity, and failed antibiotic treatment is presented.
• The patient underwent a two-level lateral corpectomy using a retro-pleural approach.
• Key surgical techniques, anatomical considerations, and postoperative management are detailed.

Findings:

• The mini-open retro-pleural approach provides excellent access to the thoracic spine pathology and neural elements.
• This technique avoids violation of the thoracic cavity, eliminating the need for postoperative chest tube placement.
• Detailed operative nuances, including patient positioning, dissection planes, corpectomy, cage placement, and closure, are outlined.

Implications:

• The lateral retro-pleural approach represents a valuable technique for thoracic corpectomy, potentially reducing morbidity.
• This method facilitates effective management of complex thoracic spinal conditions.
• The described technique offers a safe and efficient surgical option for spinal surgeons.