[Transthoracic approach to the spinal column]

Area of Science:

• Neurosurgery
• Thoracic Surgery
• Spinal Surgery

Background:

• Anterior spinal lesions present challenges for surgical access.
• Posterior approaches are often insufficient for certain spinal pathologies.
• Thoracotomy offers a viable alternative for accessing anterior spinal column.

Purpose of the Study:

• To evaluate the efficacy and safety of thoracotomy for treating anterior spinal lesions.
• To assess the range of spinal pathologies amenable to this surgical approach.
• To determine the morbidity and complication rates associated with thoracotomy for spinal surgery.

Main Methods:

• Retrospective analysis of 56 patients undergoing thoracotomy for anterior spinal lesions between 1990 and 1997.
• Surgical approach involved left-sided or right-sided thoracotomy, with diaphragm dissection for thoracolumbar access in 66.1% of cases.
• Orthopedic treatment included autologous bone grafts and Kaneda splint placement in 57.1% of patients.

Main Results:

• 56 patients (mean age 38.4 years) with diverse spinal lesions (trauma, deformities, tumors, disc herniations, Pott's disease, osteolysis) were treated.
• Overall morbidity was low at 7.1%, with complications including pneumothorax, wound infection, and ileus.
• Successful treatment was achieved, with only one patient requiring re-operation due to splint malplacement.

Conclusions:

• Thoracotomy is a valuable surgical option for accessing and treating anterior spinal lesions.
• The procedure demonstrates good clinical results with acceptable morbidity.
• This approach expands treatment possibilities for complex spinal conditions.