Microsurgical anatomy and related techniques to an anterolateral transthoracic approach to thoracic disc herniations

The microsurgical anatomy and related techniques of a modified anterolateral transthoracic approach to the thoracic disc space is presented. This procedure was performed on at least three thoracic levels of 12 cadavers within a few hours after death. Such an approach allows a safe decompression of the spinal cord and roots under full visual control. There is minimal risk to radiculomedullary vessels, minimal osteoligamental resection, and no compromise of stability of the spinal column. Therefore, this procedure does not require surgical stabilization of the spinal column, postoperative bracing, or prolonged bed rest. The difference between this approach and anterolateral transthoracic, posterolateral, and transpedicular approaches is discussed.