The extreme lateral approach to thoracic disc herniations: technique and preliminary results

The extreme lateral approach to the thoracic disc spaces produces minimum disruption of the normal spinal anatomy, avoids retraction of the spinal cord, and preserves the intercostal neurovascular bundle. It is achieved by removal of about 5 cm of the rib which has its insertion at the disc level, if necessary associated with partial removal of the transverse process, followed by partial pediculotomy and a limited lateral rachitomy (vertebral body resection), which permits the opening of the spinal canal exclusively ventral to the intervertebral foramen. The initial results of 6 patients, operated in up to four discs at the same occasion, are promising.