The lateral extracavitary approach to the spine using the three-quarter prone position

A three-quarter prone position for the lateral extracavitary operative approach to the thoracic and lumbar spine is described. This approach has been used in 40 patients with anterior spinal cord compressive lesions in the thoracic and/or lumbar region. In this patient population, it has allowed a safe ventral decompression of the spinal cord. It also allows placement of spinal instrumentation through the same incision. Both the operating surgeon and the assistant have an excellent view of the operative site, including the dural sac. Patient positioning and the operative approach are described and illustrated.