Open approaches to posterior mediastinal tumors and the spine

Open operations continue to be the appropriate approach in the diagnosis and treatment of many posterior mediastinal lesions. Transthoracic approach to the spine is required for appropriate access to allow complex reconstructive procedures to be done. The surgeon must be aware of the anatomic details of the region to avoid disabling neurologic injuries and allow precise and appropriate surgical management. Thoracoscopic approaches are now being used in some situations. The role of open and thoracoscopic techniques in the treatment of mediastinal and spinal problems will certainly continue to evolve as experience with newer techniques increases.