Safety of thoracic transverse process fixation: an anatomical study

An anatomical study of the passage of the implant placed around thoracic transverse process was undertaken in human cadavers to investigate the safety of thoracic transverse process fixation. A simulated surgical procedure for implant placement around the transverse processes of T1-T10 was carried out in eight fresh human cadavers using a mock plastic implant, 7.0 mm wide and 1.5 mm thick. A total of 80 implanted thoracic vertebrae were dissected systematically. One implanted spinal column was sectioned sagittally through the costotransverse space. The parietal pleura, the intercostal vessels, and intercostal nerves were not injured by the implants in any of the specimens. All the implants were located posterior to the intercostal nerves and vessels, lateral to the pedicles, and outside the spinal canal. The transverse processes of T1-T10 are safe structures for implant anchorage in posterior spinal instrumentation.