Summary of Key Points Thoracoscopic access to the anterior thoracic spine should be considered as a minimally invasive alternative to traditional open and mini-open procedures. Thoracoscopy can be used along the entire thoracic spine (T1 to T12) and can be…
Summary of Key Points Patient selection is paramount when choosing a lateral approach for a thoracic decompression. Fluoroscopy or stereotactic navigation is critical to define the anteroposterior and lateral axes before incision. Mastery of the lateral anatomic constraints of the…
Summary of Key Points Transpedicular approaches can provide excellent access to ventral pathology and provide the option for a partial or complete corpectomy. Minimally invasive transpedicular extracavitary options are increasingly used. Retropleural thoracotomy provides a short surgical approach to the…
Summary of Key Points Posterior approaches are the cornerstone of thoracic spine surgery and are associated with decreased morbidity relative to anterior approaches. The four primary approaches are: midline, transpedicular, costotransversectomy, and lateral extracavitary. The optimal surgical approach depends upon…
Summary of Key Points Construct design is an essential part of the planning process when addressing instability or deformity of the spinal column. Spinal implants provide internal stabilization until bony fusion occurs. The goals of spinal instrumentation are to immediately…
Summary of Key Points Cervical spine trauma, malignancy, ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis, kyphotic deformity, and cervical spondylotic myelopathy are all pathologies for which a combined surgical approach may be biomechanically advantageous when both ventral and dorsal elements are…
Summary of Key Points Cervical disc arthroplasty is a safe and effective alternative to anterior cervical discectomy and fusion in selected patients with symptomatic cervical radiculopathy or myelopathy related to cervical degenerative disc disease. The advantages of cervical arthroplasty include…
Summary of Key Points Anterior subaxial fixation techniques have greatly evolved since first being described in the 1950s. Current fixation techniques involve a combination of modular interbodies, titanium plates, and screws. The composition of the interbodies (titanium, allograft, etc.) and…
Summary of Key Points Cervical soft disc herniation can lead to a variety of presentations Nonsurgical management is often successful. Anterior cervical discectomy and fusion, cervical total disc replacement, and posterior cervical laminoforaminotomy are all safe and efficacious procedures with…
Summary of Key Points Anterior cervical discectomy provides rapid relief from radicular arm pain and halts progression of myelopathy. Corpectomy is indicated for anterior spinal cord compression between the disc spaces. Completeness of discectomy and corpectomy is based on intraoperative…