Safety of thoracic transverse process fixation: an anatomical study

Area of Science:

• Anatomy
• Orthopedic Surgery
• Spinal Instrumentation

Background:

• Posterior spinal instrumentation frequently utilizes thoracic transverse processes for implant anchorage.
• Assessing the anatomical safety of this fixation method is crucial for preventing surgical complications.

Purpose of the Study:

• To investigate the anatomical safety of thoracic transverse process fixation.
• To evaluate potential injury to adjacent structures during implant placement.

Main Methods:

• Anatomical study using eight fresh human cadavers.
• Simulated surgical placement of mock implants (7.0 mm wide, 1.5 mm thick) around T1-T10 transverse processes.
• Systematic dissection of 80 implanted thoracic vertebrae and sagittal sectioning of one specimen.

Main Results:

• No injuries to the parietal pleura, intercostal vessels, or intercostal nerves were observed.
• All implants were positioned posterior to neurovascular structures and lateral to pedicles.
• Implants remained outside the spinal canal.

Conclusions:

• Thoracic transverse processes (T1-T10) are safe anatomical structures for implant anchorage.
• Posterior spinal instrumentation using thoracic transverse process fixation demonstrates a low risk of neurovascular injury.