Related Experiment Video
Updated: Aug 24, 2025

Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Short segment rib resection to mitigate risk of pleural violation during retropleural lateral thoracic interbody
Bo Li1,2, Gregory A Kuzmik1, Saman Shabani1
1Department of Neurosurgery, University of California, San Francisco, California; and.
Abstract:
It can be difficult to avoid violating the pleura during the retropleural approach to the thoracolumbar spine. In this video, the authors resect a short segment of rib to allow more room for pleural dissection during a minimally invasive (MIS) lateral retropleural approach. After a lateral MIS skin incision, the rib is dissected and removed, clearly identifying the retropleural space. The curvature of the rib can then be followed, decreasing the risk of pleural violation. The pleura can then be mobilized ventrally until the spine is accessed. Managing the diaphragm is also illustrated by separating the fibers without a traditional cut through the muscle. The video can be found here: https://stream.cadmore.media/r10.3171/2022.3.FOCVID21138.

