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Related Experiment Videos

Extracoelomic approach to the spine

R Moskovich1, D Benson, Z H Zhang

  • 1Hospital for Joint Diseases Orthopaedic Institute, New York, NY 10003.

The Journal of Bone and Joint Surgery. British Volume
|November 1, 1993
PubMed
Summary

A novel transthoracic approach provides direct access to the thoracic vertebral column by retracting the pleura. This extrapleural technique simplifies spinal surgery and benefits orthopaedic, vascular, and neurosurgical procedures.

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Area of Science:

  • Neurosurgery
  • Orthopaedic Surgery
  • Thoracic Surgery

Background:

  • Traditional transthoracic approaches to the thoracic spine often involve transgressing the intrapleural space.
  • Exposure of the vertebral bodies can be challenging and may lead to complications.

Purpose of the Study:

  • To describe a modified transthoracic approach for direct access to the thoracic vertebral column.
  • To present a technique that avoids entering the intrapleural space.
  • To highlight the applicability to thoracolumbar and other surgical procedures.

Main Methods:

  • Detachment and retraction of the parietal pleura from the chest wall.
  • Retraction of the visceral pleura and lung contents, maintaining the integrity of the intrapleural space.
  • Extension to a thoracoabdominal approach for thoracolumbar exposure with extrapleural and extraperitoneal dissection.

Main Results:

  • Direct access to the thoracic vertebral bodies is achieved without violating the intrapleural space.
  • The technique simplifies management of costophrenic detachment.
  • The approach is adaptable for thoracolumbar spinal column exposure.

Conclusions:

  • This modified transthoracic approach offers a safe and effective alternative for thoracic and thoracolumbar spine surgery.
  • The extrapleural technique presents significant advantages for orthopaedic, vascular, and neurosurgical interventions.
  • Simplified surgical access and reduced intrapleural complications are key benefits.

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