Surgical approaches to the thoracolumbar spine

Surgical treatment of diseases involving the thoracolumbar spine offers a unique challenge to the spine surgeon. Although more familiar posterior techniques are useful for a variety of thoracolumbar problems, the management of disease in this region is often optimized by an anterior approach. Thoracolumbar surgery requires an understanding of the relevant surgical anatomy, the pathologic processes affecting this region, and the relative indications and contraindications for particular operative strategies. It is also essential to be familiar with the management of potential morbidity, methods for avoiding complications, and the selection of particular fusion techniques and instrumentation devices associated with specific operative strategies.