Transthoracic anterolateral decompression for thoracic spinal lesions

Since 1978, the authors have treated 11 patients with lesions of the ventral thoracic spine via a transpleural anterolateral approach. Each of the patients presented with pain and paraparesis, 8 had sensory dysfunction, and 6 had demonstrated sphincteric disturbances. All 11 had radiographic confirmation of anterior cord compromise, and each underwent an anterior decompression, with 8 requiring graft stabilization. There were no surgical mortalities, and the postoperative complications were limited. In follow-up, 10 of the 11 patients had complete resolution of their preoperative pain and were able to ambulate independently. Remission of sensory disturbances was noted in 6 patients, and 5 regained sphincteric control. The authors have found that this approach is both safe and effective, with several advantages over conventional laminectomy and posterolateral techniques.